Preventive / Diagnostic Services. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. Contact Us. - Copay: The fixed dollar amount you pay for a service covered under your dental plan. The wording contained within this Plan Description may be revised at any time for clarification purposes without prior notice. See Medical Summary Plan Description. Do I Need to Buy a Dental Plan? your agreement or call our Customer Service team at 800.234.3375. Plans can be designed to be 100% employer paid, a shared cost between employer and employee, or 100% employee paid. You should always talk to your health care professionals for information concerning diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. Co-insurance. DELTA DENTAL Premier Plan (PPO) DELTACARE USA- PLAN (HMO) ... HOW TO FIND OR CONFIRM IF A DENTIST IS A MEMBER 800-765-6003 Refer to the DeltaCare USA Evidence of Coverage (EOC) or contact DeltaCare at 800-422-4234 SPECIALTY REFERRALS Free choice by member Specialist Services must be referred by an assigned DeltaCare USA dentist. Here are the benefits of creating an account. Delta Dental of North Carolina provides the broadest access to the most a˚ordable oral health care to families and individual customers. © Copyright 2020 Delta Dental Plans Association. Delta Dental PPO™ For Individuals and Families. Click on the links below for more information on your 2019 plan. Delta Dental Patient Direct is a dental service discount plan. Explore our PPO, Dental HMO, managed, and discount dental plans, and learn about the different types of dental insurance coverage we offer using the chart below. DEDUCTIBLE One time $50 per family None MEMBER … Coverage for the unexpected: Oral health problems can appear unexpectedly. 6 This not only gives you a great selection of qualified dentists to choose from, but increases the likelihood that your dentist already participates in the network. Refer to your benefit plan to determine whether preventive services are covered for you. 0 Connecticut, writes Dental coverage on an insured basis in Connecticut. Delta Dental Select Plan (High option) - Providers exclusively participating in the Delta Dental Premier Network (not a Delta Dental PPO participating dentist) may charge the covered person for any additional cost of treatment over the PPO fee but no more than the Premier allowable charge. Eligible Dependents • Your spouse or same sex domestic partner. Therefore, it is always best to confirm information with your health care professionals. Cost estimates for services provided by out-of-network dentists (available in the out-of-network estimator) are based upon submitted claims data for out-of-network providers. Connect with your Delta Dental company to learn more. January 1, 2021 – December 31, 2021 . What should I look for when shopping for dental insurance? The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. All Rights Reserved. Dentist Network*: PPO, Premier (Prmr) or Out-of-Network (OON) PPO Prmr OON. You will be directed to your local Delta Dental website. Group- and state-specific exceptions may apply. This can also be referred to as out-of-pocket costs. Benefit Period Maximum (Per Person) $2,000 . SM. I receive dental insurance through my employer, Tips for choosing the best dental insurance company. The copay for crown fusion will increase from $50 to $150; What the Plans Cover Delta Dental PPO. Encourage routine dental care for long term benefit: During preventive check-ups, your dentist is better able to detect problems early on and help you avoid more costly and complex procedures in the future. DeltaCare USA is Delta Dental’s dental HMO, which offers low-cost dental coverage with a focus on preventive care. Pre-authorizations or referrals are required for certain benefit plans and certain dental care providers. endstream endobj startxref DeltaCare® USA 276 KB 3. January 1, 2021 . Individual + Child(ren) $88.00. Effective Date . The information and content (collectively, "Content") on this website is for your general educational information only. Delta Dental PPO Typically results in the lowest out-of-pocket cost for care. The replacement of crowns and/or prosthodontics is covered once every 7 years, rather than every 5 years. Save with PPO Visit a dentist in the PPO1 network to maximize your savings.2 These dentists have agreed to reduced fees, and you won’t get charged more Are you at risk for oral health problems like gum disease and tooth decay? Explore our PPO, Dental HMO, managed, and discount dental plans, and learn about the different types of dental insurance coverage we offer using the chart below. Changes in enrollment status will be considered … By encouraging preventive care, this dental program is designed to help contain den- tal costs. First, evaluate your individual needs and understand your budget. Delta Dental PPO™ Eligibility Primary enrollee, spouse (or domestic partner) and eligible dependent children to the end of the month that dependent turns age 26 Deductibles Delta Dental PPO dentists: None Non-Delta Dental PPO dentists: $75 per person each … Thanks to over 140,000 dentists in the network it's likely most people will be able to find a dentist near to them. Family. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. Total number of claims: 57,692 Total number of denied claims: 11,844 Total number of claim appeals: 0 (Zero) Grace Periods and Claims Pending Policies During the Grace Period. Our Dental Care Cost Estimator tool provides estimated cost ranges for common dental care needs. DD LG PPO 2019. Benefit Period . This means that you pay only the deductible and coinsurance for these services. With this plan, even if your Delta Dental Premier dentist is not in the PPO network, you still receive the benefit of that dentist's contracted fee. FOR COVERED EMPLOYEES OF: Supplemental Select Plus Plan (See Dental Benefit Handbook for definitions of capitalized terms.) The Dental Care Cost Estimator sometimes groups together, into "treatment categories," services that are often delivered together to address a particular dental problem. Cost estimates are specific to geographic areas, as defined by the first three digits of a ZIP code (e.g., the geo ZIP for 12345 is 123). Answer a few questions, get results and share them with your dentist. At renewal you will be moved to our PPO plus Premier Plan B Prime. GROUP NUMBER: 50319 – 00000 . If you live outside the U.S., you may see information on this cost estimator about products or services that are not available or authorized in your country. Delta Dental Individual PPO, EHB Certified (Exchange) is an individual dental health plan issued by Delta Dental Plan of Indiana, Inc. and is available for the year 2019. Use of this website in no way increases or decreases the benefits available under a dental benefit plan. 2019 Effective Dates One-year contract 2 8/2018 Certified EHB Benefits (for members under the age of 19) Delta Dental PPO Delta Dental Premier / Nonpar Covered Services Diagnostic & Preventive Services 90% 80% Exams, cleanings, fluoride, space maintainers, radiographs, and sealants Emergency Palliative 100% 100%. Option 1: Delta Dental PPO℠ – Select Plan. Silver Bronze. Delta Dental covers eight out of 10 providers in the country. Delta Dental PPO is our preferred-provider option program. Benefit Period Maximum (Per Person) $2,000 . Delta Dental PPO plus Premier Plan A. Do not avoid getting dental care based on the cost information provided on this website. The dental plan rates are good through July 2019. What is some dental insurance terminology I should know? That's why keeping smiles healthy is what we do. PPO features additional cost-saving protections by giving enrollees access to two Delta Dental dentist networks of different sizes with different levels of savings. Delta Dental of New Jersey, Inc. covers more than one million people in commercial, school board, and government programs. *Not sure where your company is headquartered? Click on the links below for more information on your 2019 plan. Get started here. IND Family Advantage Plan 2019 INDFA 20190101 Coverage for a Newborn, Adopted or Foster Child A newborn is covered from the moment of birth, and an adopted child is covered from the date of assumption of a legal obligation for total or partial support of the child or upon placement of the child in anticipation of adoption. You will also want to look at network size and applicable restrictions. Thanks to over 140,000 dentists in the network it's likely most people will be able to find a dentist near to them. A healthy smile can make all the difference. Individual + Spouse. Improved overall health: Research shows good oral health has a positive effect on overall health and well-being. Do I Need to Buy a Dental Plan? In this incentive plan, Delta Dental pays 70% of the PPO contract allowance for covered diagnostic, preventive and basic services and 70% of the PPO contract … Estimates should not be construed as financial or medical advice. At Delta Dental, we offer a wide variety of affordable individual dental insurance plan options. PPO features additional cost-saving protections by giving enrollees access to two Delta Dental dentist networks of different sizes with different levels of savings. Thank you for choosing Delta Dental to protect your smile and improve your health. You may be responsible for the cost of procedures or services not covered by your plan. Benefit Summary . %%EOF Consider and try to anticipate the specific coverage needs of each member of your family and evaluate which plan is financially feasible by looking at things like annual maximums and deductibles, along with the type of services that are covered, to ensure that you will receive the level of care your family needs. The secure version (available only after you sign in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data. Estimates should not be construed as financial or medical advice. Benefit Period . The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. If you are currently undergoing active orthodontic treatment, you may be eligible to continue treatment under Delta Dental PPO. Individual and family dental insurance plans. The data is based on actual, non-discounted charges that providers have billed. Affordable Dental Coverage for People 65 and Over. Does dental insurance cover cosmetic procedures? Delta Dental PPO gives employers the ability to enjoy both maximum savings and all the features of other Delta Dental plans. DELTA DENTAL PPO PLUS PREMIER NETWORK PLAN DESCRIPTION EFFECTIVE JANUARY, 2019. Delta Dental claim form 938 KB 2. Network: Delta Dental PPO ℠ Choosing a network dentist Annual maximum: $1,000 Deductible: $100 Service. UAW 1069 . The premiums for 2019 are competitive relative to the coverage benefits, dentist network, and maximum dollar benefit of other dental insurance plans on the market. Delta Dental PPO plus Premier Plan A. We offer group dental plans for large and small businesses that utilize two robust networks: Delta Dental Premier® and Delta Dental PPO. If you began treatment prior to your effective date of coverage, you or your prior carrier is responsible for any costs. 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