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UPMC Dental Advantage - Empowering employees to take control of their oral health

UPMC Health Plan has a long, proud history of providing high-quality benefit plans, extensive provider networks, and unparalleled customer service for our members. This commitment extends to UPMC Dental Advantage, which offers preferred provider organization (PPO) plan designs, each with a vast network of providers.

UPMC Dental Advantage is designed to encourage regular preventive care, which is important for your employees’ dental and overall health. A dentist can detect many serious illnesses during a routine checkup, including diabetes, osteoporosis, and eating disorders. Encouraging open communication between your employees and their dentists about oral health and appropriate treatment plans is a key component of our coverage.

UPMC Dental Advantage plan highlights

  • UPMC Dental Advantage does not require prior authorization for major services.
  • Members do not need an ID card to receive treatment. They just need to provide the dentist’s office with some basic demographic information. The provider will then verify the member’s eligibility for services. Members who want an ID card can view a digital version using the UPMC Health Plan mobile app.
  • There is no waiting period and no denial of coverage of benefits if members have pre-existing dental conditions.
  • UPMC Dental Advantage offers PPO plans, so members do not have to select a primary dentist. They can receive care from any in-network provider. Members may go out-of-network, but they would then be responsible for a higher share of the cost.
  • Employees will have access to outstanding customer service from our Health Care Concierge team. Members of this team are dedicated to answering questions about UPMC Health Plan benefits, including dental coverage.
  • We provide access to MyHealth OnLine, a secure website where members can find information about their UPMC Dental Advantage plan and other UPMC Health Plan benefits.
  • UPMC Dental Advantage plans offer enhanced benefits including:
    • One additional cleaning for pregnant members
    • Coverage for nonsurgical periodontal treatment, including topical application of fluoride for adults with a history of surgical periodontal treatment
    • Coverage for microbial tests and brush biopsies
    • Class I diagnostic and preventive services do not count toward members’ benefit limit. That leaves more benefit dollars for other covered dental procedures.

You can purchase UPMC Dental Advantage as a standalone benefit or integrate it with your UPMC Health Plan medical coverage. Plan options are available for employer groups of all sizes. Employers with 51 or more eligible employees can bundle dental, vision, and hearing health care benefits with their UPMC Health Plan medical coverage. Employers with 2 to 50 eligible employees can pair dental and vision with UPMC Health Plan medical coverage.

To learn more about UPMC Dental Advantage options, contact your producer or call 1-833-825-2696.

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Find out more about our employer group coverage:

Contact your producer or call 1-833-825-2696

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Sources

1 Fast facts of common eye disorders. Centers for Disease Control and Prevention. Updated June 9, 2020. Retrieved Sept. 27, 2021. cdc.gov/visionhealth/basics/ced/fastfacts.htm

2 Huot P. Three reasons to jump on the vision benefits bandwagon. Society for Human Resource Management. SHRM. Published July 30, 2012. Retrieved Sept. 15, 2021. shrm.org/ResourcesAndTools/hr-topics/benefits/Pages/VisionBenefits.aspx.

3 Schaneman J, Kagey A, Soltesz S, Stone J. The role of comprehensive eye exams in the early detection of diabetes and other chronic diseases in an employed population. Popul Health Manag. 2010;13(4):195-199. doi:10.1089/pop.2009.0050