Overview

Dental Wisconsin is a supplemental dental plan that offers comprehensive dental coverage. Dental Wisconsin offers two plan options, providing you and your family the opportunity to utilize a broad network and choose a dental benefit that meets your needs. Dental Wisconsin is offered through EPIC Specialty Benefits.

Dental Wisconsin plan options:

  • PPO Plan
  • Select Plan

Although there are two plan options to choose from, the following items apply to both the PPO and Select Plans:

  • Annual benefit maximum per individual: $1,000
  • You and your covered dependents must serve a 3-month waiting period for basic and major services and a 12-month waiting period for orthodontic services if you do not have prior creditable dental coverage
  • Utilizes the Delta Dental of Wisconsin network—you may see the dentist of your choice, but will have lower out-of-pocket costs if you see in-network dentists
  • Includes the Affinity Vision Discount Program which offers members discounts on professional vision services and products. Note: This is not an insurance plan, but rather a savings opportunity through the Davis Vision network.
See the Plan Brochure for plan details.

Eligibility

You must meet the following requirements to be eligible for this plan:

For detailed information regarding who you can cover on this plan, see the Dependent Eligibility Grid (UWS 25).

PPO Plan

The PPO Plan provides coverage for annual cleanings and x-rays, in addition to partial coverage for fillings, crowns, implants, and more. The PPO Plan offers in-network and out-of-network coverage, so you may see the dentist of your choice. However, you will have lower out-of-pocket costs if you see a Delta Dental PPO provider.

Not sure if your dentist is a Delta Dental PPO provider? Call Delta Dental at 800-236-3712 or visit Delta Dental on the web at deltadentalwi.com/state-of-wi or contact your dentist directly.

Select Plan

The Select Plan does not provide preventive or diagnostic coverage. This means that cleanings and/or routine x-rays are not covered under this option so it may be a good option if you have elected Uniform Dental coverage with your health insurance. The Select Plan provides partial coverage for fillings, crowns, implants, and more. The Select Plan has an open network, so you may see the dentist of your choice. However, you will have lower out-of-pocket costs if you see a Delta Dental Premier provider.

Not sure if your dentist is a Delta Dental Premier provider? Call Delta Dental at 800-236-3712 or visit Delta Dental on the web at deltadentalwi.com/state-of-wi or contact your dentist directly.

Enrollment

You have 30 days from your date of employment or your newly benefits-eligible job to enroll yourself and eligible family members in Dental Wisconsin. Your coverage will begin on the first of the month on or following your eligibility date.

If you do not enroll in Dental Wisconsin or did not include dependents on your plan during your initial 30-day enrollment period, you may enroll when offered during the Annual Benefits Enrollment period or if you have a qualifying life event. See Life Events for more information.

Once you are enrolled in Dental Wisconsin, you must remain enrolled for the calendar year.

Waiting Periods

There is a 3-month waiting period for basic and major services, and a 12-month waiting period for orthodontia services under the Dental Wisconsin program. If you are changing coverage from other comparable dental insurance to Dental Wisconsin, these waiting periods may be waived by completing a Certification of Dental Coverage Form and submitting it directly to EPIC Specialty Benefits. EPIC Specialty Benefits will make the final determination.

Premiums

For Dental Wisconsin premiums, see the Premiums page.

Forms & Resources


last updated: 12/9/16