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BMO U.S. Benefits

Dental

BMO offers comprehensive dental coverage through the Delta Dental PPO plan. You can see any dentist you want, however, you can save money by going to a Delta Dental PPO or Delta Dental Premier network dentist. Delta Dental of Illinois administers the plan.

Here’s a high-level overview of the Dental Plan. For details, review the Dental SPD.

Features
Annual Benefit Maximum$2,000 per person
Lifetime Non-surgical TMJ Maximum$1,000 person
Finding a doctor

You’ll maximize your benefits by receiving care from a Delta Dental PPO or Delta Dental Premier network dentist:

  • Delta Dental PPO: Lowest out-of-pocket costs and network protection
  • Delta Dental Premier: Higher out-of-pocket costs than PPO, but may be lower than non-network and network protection
  • Non-network: You may have the highest out-of- pocket costs

Non-network dentists have not agreed to accept Delta Dental’s reduced fees as payment in full. Payment is based on the lesser of the Delta’s usual fee or maximum plan allowance. Non-network dentists can charge amounts exceeding the maximum plan allowance.

What You Pay
Annual Deductible
  • Individual coverage: $50
  • Family coverage: $150
Preventive Services
  • Routine exams (two per calendar year)
  • Cleanings (two per calendar year)
  • X-rays (bitewings — one set per calendar year; full mouth — once every three years)
  • Fluoride treatments (twice per calendar year for dependents under age 19)
  • Space maintainers
  • Sealants
$0
Basic Services
  • Fillings (amalgam and composite on front teeth)
  • Posterior composites
  • Emergency exams & pain relief
  • Treatment
  • Endodontics
  • Periodontics
  • Simple extractions
  • Oral surgery
  • General anesthesia (in conjunction with oral surgery)
  • Denture relines, repairs, rebase and adjustments to dentures
20%
Major Services
  • Partial/full dentures
  • Fixed/removable bridges
  • Implants
  • Cast restoration-crowns, onlays, post and core
  • Non-surgical TMJ
50%
Orthodontic Care Up to $1,500 separate lifetime maximum per individual, up to age 1950%

Enhanced Benefits Program

The Delta Dental Enhanced Benefits Program integrates medical and dental care for individuals with specific health conditions.(e.g., diabetes, kidney failure, periodontal disease, pregnant women).

Here’s what you need to do to enroll in the program:

  • Sign into Member Connection on Delta Dental
  • Select the Enhanced Benefits tab
  • Enter health information for you or your dependents to qualify for the extra benefits