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Farm Bureau Health Plans

DentalVision Silver

For years, Farm Bureau Health Plans has been providing plans that close the gaps in Medicare coverage and give you the protection and peace of mind you need.

That’s why we’re proud to offer DentalVision Silver. Specifically designed for people over 65, DentalVision Silver provides insurance for dental and vision costs not paid by Medicare with an affordable monthly premium  of $39.75 - that's less than $1.50 a day for the assurance of knowing that your dental and vision needs will be covered.

DentalVision Silver Overview

Dental Monthly Premium

$39.75

per person
Dental Annual Deductible

$100

Dental Annual Maximum Benefit

$1,500

Vision Copay for Refractive Exams

$15

Vision Copay for Frames and Lenses

$35

Frames every 2 years/Lenses every year
Vision Allowance For Contacts

$100

per year
Dental Benefits
Highlights
  • Administered by Delta Dental of Tennessee PPO Standard Network
  • Annual deductible is $100
  • Annual maximum benefit is $1,500
  • First day coverage for routine exams and cleanings, subject to the deductible
  • Other procedures (fillings, extractions, root canals) subject to 180-day waiting period

Click Here for a complete summary of dental benefits.

Vision Benefits
Highlights
  • Eye-care benefits administered by VSP
  • $15 copay for refractive exams
  • $35 copay for frames (every 2 years), lenses (every year)
  • $100 allowance for contacts per year

Click Here for a complete summary of vision benefits.

DentalVision Silver - Delta Dental
Dental Benefit

Dental Benefit

Description

Description

Coverage

Coverage

Routine exams, cleanings and x-rays
No waiting period
80%
Basic (fillings, simple extractions)s
180-day waiting period*
80%
Endodontics (root canals)
180-day waiting period*
50%
Periodontics (gum disease)
180-day waiting period*
50%
Complex oral surgery (surgical extractions)
180-day waiting period*
50%
Major (crowns, bridges)
180-day waiting period*
50%
Annual maximum
$1,500
Deductible
$100 annual deductible (applies to all services)

* 180-day waiting period does not apply to Diagnostic and Preventative Services. If you enroll within the first six months of your 65th birthday or within six months of enrolling in Medicare Part B, you will not be subject to the 180-day waiting period for all other covered services.

List of Delta Dental’s network of providers
Please click here for a printable application
Please click here for the DentalVision Silver Schedule of Benefits

YOUR COVERAGE WITH A DENTALVISION SILVER PROVIDER

WellVision exam

  • Focuses on your eyes and overall wellness
  • Every calender year

Copay: $15

Prescription glasses

Copay: $35

Frame

  • $100 allowance for a wide selection of frames
  • $120 allowance for featured frame brands
  • 20% savings on the amount over your allowance
  • Every other calendar year

Copay: ncluded in prescription glasses

Lenses

  • Single vision, lined bifocal and lined trifocal lenses
  • Polycarbonate lenses for dependent children
  • Every calendar year

Copay: Included in prescription glasses

Lens enhancements

  • Standard progressive lenses
  • Premium progressive lenses
  • Custom progressive lenses
  • Average savings of 20%-25% on other lens enhancements
  • Every calendar year

Copay: No copay

Contacts

(Instead of glasses)

  • $100 allowance for contacts every calendar year

Copay: No copay

  • Contact lens exam (fitting and evaluation) every calendar year

Copay: Up to $60

Your Coverage With A VSP Provider
Extra Savings

Glasses and sunglasses

  • Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details
  • 20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision exam

Retinal screening

  • No more than a $30 copay on routine retinal screening as an enhancement to a WellVision exam

Laser vision correction

  • Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities
YOUR COVERAGE WITH AN OUT-OF-NETWORK PROVIDER

Exam up to $45

Frame up to $70

Single vision lenses up to $30

Lined bifocal lenses up to $50

Lined trifocal lenses up to $65

Progressive lenses up to $50

Contacts up to $85

DentalVision Silver guarantees coverage from VSP network providers only. Coverage information is subject to change. In the event of a conflict between this information and Farm Bureau Health Plans’ contract with VSP, the terms of the contract will prevail. Based on applicable laws, benefits may vary by location.

List of VSP's network of eye care providers
Click here for a printable application
Please click here for the DentalVision Silver Schedule of Benefits

Provider Network

FBHP's DentalVision Silver utilizes the Delta Dental PPO and VSP Choice networks. This may not be a complete list of all providers. Once enrolled, you will have access to a complete list.

Schedule of Benefits

This schedule is intended to be used to help you compare coverage benefits and is a summary only.

Enroll today!

Make the right choice for your health; choose Farm Bureau Health Plans.

Visit a Farm Bureau Office

There are 195+ offices throughout Tennessee, so stop by and see us.

For More Information, call

1-877-874-8323