Mt. Lebanon Rehabilitation and Wellness Center (Comprehensive)
You are eligible to enroll in Dental benefits through your facility.
One of the advantages of this Dental Plan is that you can find out how much will be paid by the Plan before you have the dentist do expensive work.
If the dentist’s estimated charge is $300 or more, you can get a “Predetermination of Benefits.” This will NOT be a guarantee of payment, but it will help you estimate what you will receive.
Dental treatment has different "Grades" with different levels of coverage. These range from Grade I for preventative care to Grade V for orthodontics.
Preventative care is covered at 100% of “Reasonable and Customary” charges. Grades II, III, IV, and IV are covered at 50% of “Reasonable and Customary” charges.
For a full description of what is covered and the maximum allowable benefits, please see the plan document, here.
If you are enrolled and need to send in for reimbursement, download this form. Send it in with your receipt or take it in with you when you visit the dentist.
If you have questions about how to get a Predetermination of Benefits or help finding a dentist, call the Health and Welfare Plan at 1-800-877-6490.
You may be eligible to enroll in Vision benefits through your facility. To verify that you are enrolled contact your human resource department.
You will receive a vision card from SEIU Healthcare PA Health and Welfare Plan.
As an eligible participant, you are covered for 100% (reasonable and customary) of a Complete Eye Examination and Refraction.
You are also eligible for $200.00 toward Lenses and Frames (combined) or Contact Lenses.
The vision benefits are not payable for more than one (1) exam and pair of lenses/frames in any twenty-four (24) calendar month period per eligible adult.
Children, up to age 19, are eligible for this benefit every twelve (12) months.
You must file a claim form to the plan within one (1) year of the charges in order to use the vision care benefits. Use this form for reimbursement.
Additional exclusions and limitations apply.
For a full description of benefits, read the full summary of vision benefits below.
If you have questions regarding your Vision Benefits, please call the Health and Welfare Plan at 1-800-877-6490.