DeltaCare USA Prepaid Dental Plans

Dental plans with a comprehensive range of specialty services

In an age of rising healthcare costs, DeltaCare USA prepaid dental plans offer employers and employees a cost-effective approach to dental care. DeltaCare USA has become one of the largest prepaid dental programs in America, providing employees with an extensive network of participating dentists.

DeltaCare USA. Enrollees enjoy the savings and predictability of a dental program that provides preventive and restorative care on a monthly, capitated basis. There's no paperwork, no maximum or deductible, and no copayment for diagnostic and preventive services. Enrollees pick a dentist from a carefully screened panel to provide primary care for themselves and their families, then see the dentist in his or her own private office. Specialists are also part of the DeltaCare USA network.

Enrollees in the DeltaCare USA prepaid dental program enjoy these advantages.

Quality assurance. DeltaCare USA programs provide rigorous controls to assure quality care. Network dentist undergo on-site quality audits. Auditors examine office hours, number of staff members, convenience of location, sterilization techniques, recordkeeping, opportunities available to staff, type of equipment, continuing education, range of services provided and the dentist's own quality assurance system. Contracted dentists must have been in practice for at least five years and must be able to provide 24-hour emergency service. Once accepted into the network, the dentist's office is visited regularly by a DeltaCare USA representative.

Broad range of specialties. The DeltaCare USA panel includes oral surgeons, endodontists, pedodontists, periodontists and orthodontists. When a DeltaCare USA primary care dentist refers a patient to a specialist, the DeltaCare USA program reimburses the specialist directly for prior authorized treatment. Unlike many prepaid dental programs, DeltaCare USA doesn't require the primary care dentist to pay for specialty care, a practice which encourages appropriate referral. (The patient pays the same copayment for specialty care services whether performed by the primary care dentist or by a referred specialist.)

DeltaCare USA dentists receive a predetermined amount each month for each patient enrolled with their office. Because these dentists have already contracted to provide services to DeltaCare USA patients, there are no claim forms.

Programs are available at several levels

There are several different programs with variations in monthly premiums and in copayments. Copayments are charged per visit and/or procedure. In most programs, basic visits and procedures have no copayments at all.

DeltaCare USA offers a broad range of covered benefits

All services are covered in full or with patient copayments as shown in the schedule of benefits and copayments.

• Diagnostic and preventive services, including examinations, consultations and x-rays. Also included are prophylaxis (cleaning), topical application of preventive solutions and sealants (age limitations may apply) and space maintainers.
  
  
• Emergency services, to relieve pain and infection.
  
  
• Restorative services, including amalgam, porcelain and plastic restorations (fillings) for treatment of carious lesions (visible destruction of tooth surface resulting from the process of decay). Crowns and jackets are also covered when teeth cannot be restored with the materials mentioned above.
  
  
• Oral surgery, including extractions and certain other surgical procedures.
  
  
• Endodontics, including pulpal therapy and root canal filling.
  
  
• Periodontics, treatment of the tissue supporting the teeth.
  
  
• Fixed bridges, covered subject to administrative policies.
  
  
• Removable prosthetics, including full or partial dentures.
  
  
• Orthodontic care, for adults and/or dependent children, subject to the availability of network orthodontists.

This is a summary of benefits. For costs and further details of the coverage, including exclusions, any reductions or limitations and the terms under which the policy may be written or continued in force, see your insurance agent or contact us.

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