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Dental Plan Checkups

By Mike Causey
Washington Post Staff Writer
Friday, November 15 1996; Page B02

There are three things federal employees can do to get the most out of the dental benefits offered by their health plan.

First, inherit great teeth.

Next, brush and floss daily.

Finally, send your health plan brochure to your dentist for a checkup.

When it comes to dental benefits, all of the federal health plans have cavities. Walton Francis, who wrote the Washington Consumer Checkbook's "Guide to 1997 Health Plans for Federal Employees," says the best dental benefits are offered by health maintenance organizations (HMOs). But don't, he says, pick a health plan exclusively because of its dental benefits.

Feds and retirees can pick from dozens of plans -- fee-for-service and HMOs -- during the open season that ends Dec. 9.

Francis says many plans pay a limited benefit for things such as dental repair after an accident or for surgical procedures such as removing an impacted wisdom tooth. But many of the same plans do not cover routine care.

Brochures use confusing terms, such as "gingival" for "gum" and "amalgam restorations," which means "fillings." No plan has a catastrophic dental benefit. Francis recommends people ask their dentist -- or someone in his or her office -- to review the benefits offered by health plans. If what you need isn't covered by your dentist, you can seek another plan, get another dentist or be braced for the bill.

Francis says HMOs offer the best dental benefits. He cites Aetna, CIGNA, George Washington high option, Prudential and the Alliance (which is limited to CIA personnel). Those plans don't require a deductible or impose a maximum benefit.

"They cover preventive care in full," he says, "and reimburse most common and inexpensive procedures such as fillings." He says they cover about two-thirds of the most expensive procedures, including some orthodontic costs.

Plans covering about about half of dental costs also are HMOs: Columbia, FreeState, George Washington standard option, both Humana Group Health options, both NYLcare options, Kaiser, MD-IPA and U.S. Healthcare.

High premiums don't mean better benefits. Although the Blue Cross-Blue Shield high option plan costs much more than the standard option, the standard option has a better dental benefit. It will pay about half the cost of preventive care and inexpensive procedures (with no deductible), but it does not cover many expensive procedures.

Francis will answer questions about the federal health plans at 9 a.m. tomorrow on WUST-AM (1120).

Downsizing and Reinvention

The Office of Personnel Management's associate director, Allan D. Heuerman, will be on WUST at 10 a.m. tomorrow to talk about downsizing, restructuring and reinvention.

IRS Buyouts

The Internal Revenue Service hopes to begin making buyout offers this month, but it won't start them on Monday, as we reported earlier.

Congress has approved buyouts, but the IRS must get approval for its specific plan. Once that happens, the IRS says, the agency will begin making buyout offers within five days.

The tax agency also is reconsidering how many information service workers will be getting buyouts and when those offers will be made.

Copyright 1997 The Washington Post Co.

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