Concordia Plus
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Dental Providers - If you are enrolled in the Concordia Plus Managed Care
(DHMO) plan, you must seek services from a provider that participates in the Concordia
Plus network. More specifically, you must seek services from the provider that is listed
on your most recent insurance card. You may also call United Concordia to obtain this
information: 1-877-215-3616.
Dental providers can be changed at any time. Should you decide to change providers,
you must call United Concordia directly to make this change prior to seeking services from
that new provider. Once you have requested the provider change, United Concordia will confirm
the effective date of the change and will issue a new insurance card with the new provider’s name.
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Copayment Schedule - Only a representative sampling of copayment amounts are presented
in the University’s Summary Guide Comparison. Please refer to the Schedule of Benefits on the
Dental section of the Benefits Web site for more detailed information on the copayment amounts
for covered services. Before you begin any treatment plan, it is important to discuss actual
copayment amounts with the provider of the service.
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$5.00 Copayment - A $5.00 copayment applies to diagnostic and preventive services
received at either the University of Pittsburgh Dental School (Provider Number 154327) or the
University Dental Health Services (Provider Number 608061). A copayment does not apply to
these two types of services at any other provider..
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Orthodontic Treatment - Orthodontic treatment obtained under the Concordia Plus plan is
covered by United Concordia up to 40-50% of the scheduled allowance. Please refer to the Schedule
of Benefits on the Dental section of the Benefits Web site for actual copayment amounts. Note that
treatment must be initiated under the Concordia Plus plan and must be completed in the service
area of Western Pennsylvania by a provider in the Concordia Plus network. .
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For Pregnant Women - A third checkup and cleaning is a covered expense for pregnant women.
For further clarification on any dental items, whether presented here or not, please contact
United Concordia directly at: 1-877-215-3616.
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Flex I & Flex II
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Dental Providers & Maximum Allowable Charge (MAC) - Under either the Flex I or Flex II plans,
participants may select any provider of their choice. The network of participating, or preferred,
providers for these plans is the Concordia Advantage Network. Participating providers will accept
United Concordia's allowance (MAC) as payment in full, less any coinsurance amount(s) that are the
member’s responsibility. Thus the member will not be responsible for any amount over the MAC that
is charged by the provider. Note that deductibles may still apply and will be the responsibility
of the member.
In the event that a non-participating provider (i.e. one who does not participate in
the Concordia Advantage Network) is selected and the provider charges more than United
Concordia’s MAC, the member would be responsible for paying that amount to the provider.
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Orthodontic Treatment - Orthodontic treatment is only covered under the Flex II plan.
There is no orthodontic coverage under the Flex I plan. Under the Flex II plan, the
coverage for orthodontic treatment is 50% up to the scheduled allowance. There is a $1,500
lifetime maximum. Orthodontic treatment in progress is covered under the Flex II plan and may
be obtained by a licensed provider anywhere in the United States.
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For Pregnant Women - A third checkup and cleaning is a covered expense for pregnant
women under both the Flex I & Flex II plans.
For further clarification on any dental items, whether presented here or not, please contact
United Concordia directly at: 1-877-215-3616.
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