Providers' guide to Oral Health for Overall Health
Most employer-based Regence dental plans include the Dental4Health® program. Enrolled members receive additional dental benefits that have been shown to improve overall health and lower medical and dental care costs.
These benefits are valued at over $1,000 and are covered 100% with no out-of-pocket expenses when members see a participating provider. Eliminating out-of-pocket costs increases the likelihood of eligible patients taking advantage of the program’s benefits.
Help your patients take advantage of these valuable benefits
We regularly engage enrolled members to make sure they are aware of the relationship between preventive or periodontal dental services and their overall well-being; however, the program has a greater impact when our provider partners participate in member education, so we encourage you and your staff to help your patients understand the value of these important benefits.
Since patients in the program are eligible for four visits per year, we recommend that you schedule all four visits during their first visit.
Eligible Medical Conditions
Coronary artery disease (CAD)
Periodontal scaling covered 100%
Enhanced cleaning to remove excess plaque buildup
Two additional cleanings or periodontal maintenance visits
Diabetes (DM)
Periodontal scaling covered 100%
Enhanced cleaning to remove excess plaque buildup
Two additional cleanings or periodontal maintenance visits
Chronic obstructive pulmonary disease (COPD)
Periodontal scaling covered 100%
Enhanced cleaning to remove excess plaque buildup
Oral health screenings; fluoride treatments
Two additional cleanings or periodontal maintenance visits
End-stage renal disease (ESRD)
Periodontal scaling covered 100%
Enhanced cleaning to remove excess plaque buildup
Two additional cleanings or periodontal maintenance visits
Head and neck cancers (HNC)
Enhanced cleaning to remove excess plaque buildup
Oral health screenings; fluoride treatments
Two additional cleanings or periodontal maintenance visits
Metabolic syndrome (MetS)
Periodontal scaling covered 100%
Enhanced cleaning to remove excess plaque buildup
Two additional cleanings or periodontal maintenance visits
Oral cancer (OC)
Enhanced cleaning to remove excess plaque buildup
Oral health screenings; fluoride treatments
Two additional cleanings or periodontal maintenance visits
Pregnancy (PG)
Periodontal scaling covered 100%
Enhanced cleaning to remove excess plaque buildup
Two additional cleanings or periodontal maintenance visits
Sjogren’s syndrome (SjS)
Enhanced cleaning to remove excess plaque buildup
Oral health screenings; fluoride treatments
Two additional cleanings or periodontal maintenance visits
Stroke (CVA)
Periodontal scaling covered 100%
Enhanced cleaning to remove excess plaque buildup
Two additional cleanings or periodontal maintenance visits
Verifying patient enrollment
Members with Regence health and dental plans and eligible medical conditions affected by oral health are automatically enrolled in the program based on claims information. Members who have only a dental plan are encouraged to self-enroll. Automatic enrollment is key to the program’s effectiveness—it allows us to proactively engage those enrolled so that they understand and use the program’s services.
We recommend you thoroughly review your patients’ medical history before starting treatment. After confirming the condition(s) that led to their enrollment, please call us at 800-253-0838 or review the information on the MyDentalCoverage website. Select the Wellness Benefits tab after logging in through the My Patients’ Benefits link. Their conditions and enrollment date will be displayed—the Limitations column lists which procedures are covered for each qualifying condition.