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FAQ:
Costs and fees
Find answers to
the questions below.
Where
do I find rate information for your dental plans
on your web site?
Our web site offers pricing
information as well as online enrollment for
our individual/family plans only. These
DeltaCare programs are dental programs
that let you select one dentist from the DeltaCare
network to provide primary care for you and
your family. Click
here for information about these programs.
We do not have cost information
on our web site for group coverage since it
varies according to the requirements and characteristics
of that group. If
your employer offers Delta as one of its dental
plan choices, please contact your personnel
office for more information about rates.
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How
do I obtain information about fees for treatment?
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Talk to your
dentist
Your dentist
knows his or her approved fees and
has easy access to your individual
coverage information. Many patients
are reluctant to ask their dentist
for this information, but your dental
office will probably welcome the
opportunity to discuss fees and
your share of the cost.
Your dentist can
also request a predetermination,
or free estimate, from Delta that
identifies your payment responsibility
for a specific procedure. The predetermination
is based on your records and your
dentist's proposed treatment plan.
Delta will review your x-rays, diagnosis
and coverage, and send a statement
back to your dentist detailing what
Delta will pay, and what your costs
will be.
Read
more about predeterminations >>
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While it sounds like a simple
question, there are several factors to consider.
Delta's payment varies depending on:
The dentist you select
Most Delta programs allow
you to choose any dentist, and every Delta dentist
has a different set of approved fees on file
for each service.
Under most Delta programs,
you will have a certain percentage of coverage
(for example, 80 percent coverage for diagnostic
and preventive services such as cleanings and
x-rays). One dentist might charge $50 for a
procedure and another might be approved to charge
$75. While the coverage would always be 80 percent,
the dollar amount of the coverage and your copayment
(the remaining 20 percent) will depend on the
dentist you visited.
The program you're
enrolled in
Some Delta programs, usually
our DeltaPreferred Option (DPO) programs, offer
a higher level of coverage if you select an
in-network dentist. Others offer a higher level
of coverage if you regularly visit the dentist.
Some Delta programs, usually
our DeltaPremier table of allowance programs,
cover a certain dollar amount for each procedure.
You pay the difference between the table amount
and your dentist's approved fee. (In this case,
your employer will give you a list of the amounts
Delta will pay for each procedure.)
Other programs, usually
DeltaCare programs, specify the dollar amount
you will pay for each service. You receive a
list of these services and copayments and you
select the DeltaCare dentist who will provide primary
care for you and your family.
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How often
do I pay my deductible?
Most dental benefit contract provisions
are based on a calendar year (January through December), which
means you must meet your deductible once each year. Depending
on a dental plan's design, diagnostic and preventive benefits
may not be subject to any deductible. When a basic service
such as a filling is provided, any applicable deductible is
added to your copayment responsibility. It may take more than
one service to satisfy the entire deductible.
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