Once registered, they can use the Find a Dentist feature behind login to make dentist selections or updates. Your employer has chosen to participate in the Exchange and you have selected Delta Dental of California Delta Dental ) to meet … Primary care dentists may be able to help find an orthodontist within the DeltaCare USA network. (These companies are financially responsible for their own products.) However, benefits are not provided for any dental treatment started before joining the program (that is, work in progress, such as preparations for crowns, root canals and impressions for dentures). H0524_19SB003_M PBP 003 60872209 S 003 January 1–December 31, 2019 . helpful guide with enrollees if they have further questions. In most states, enrollees must select a primary care dentist in the DeltaCare USA network in order to receive treatment, as in a traditional HMO. See the "Limitations and Exclusions of Benefits." What is DeltaCare USA? If the orthodontist recommends x-rays, can they be done by the general dentist? This option provides excellent coverage with predictable copayments. Refer to your benefit plan to determine whether these requirements apply to you. Search for: See recent posts. as routine cleanings and exams. Box 1803 Alpharetta, GA 30023 Customer Service 888-282-9501 deltadentalins.com Delta Dental Individual & Family™ DeltaCare® USA CAA54 PB_DCU_I_CAA54_20. Created with Sketch. Most DeltaCare USA plans allow enrollees to continue treatment started under a previous dental plan. Mail to: DeltaCare USA Claims Department P.O. Orthodontic treatment in progress may be covered for new DeltaCare USA enrollees. Delta Dental. %PDF-1.6 %���� h�bbd```b``���W�$�d���j � ��+,�LV�H� R�lB#�d��>$�r���79o&F�m`3�Cr}��i����0 ~r DeltaCare USA is a dental program that provides you and your family with quality dental benefits at an affordable cost. Individual PPO plans have flexible enrollment. Dentists receive a flat fee for each member assigned to their offices. DeltaCare USA is a closed network product* that features set copayments, no annual deductibles and no maximums for covered benefits. If any services are provided by a non-DeltaCare USA Contract Dentist or specialist, you will be obligated to pay for such services. This benefit is not offered to employees represented by Fraternal Order of Police (FOP) Enrollment Information; Your Benefits; Part-time New Hire FAQ’s ; Rates; DeltaCare USA Plans - DHMO Dental Plans. Effective Date Revised Combined Evidence of Coverage and Disclosure Form Provided by: Delta Dental of California 560 Mission Street, Suite 1300 San Francisco, CA 94105 800-471-9925 deltadentalins.com Administered by: Delta Dental Insurance Company P.O. 1366 0 obj <>stream Created with Sketch. • $1,350 - $2,100 copay for adults. The plan is unique in its emphasis on preventive services, which are fully covered. DeltaCare USA is Delta Dental’s dental HMO, which offers low-cost dental coverage with a focus on preventive care. Upon enrollment, enrollees will receive a plan booklet with defined copayments for covered services. Share this Most plans cover extractions for orthodontic purposes at the listed copayment. Registration is easy – the three-step process takes just a few minutes. Enrollees must enter their location and select the DeltaCare USA network from the drop-down menu. When you enroll, you select a contract dentist to provide services. How does the orthodontic treatment-in-progress provision work? B. DELTACARE®USA COMPREHENSIVE MANAGED CARE PLAN This plan offers a broader range of benefits including some restorative dental procedures (fillings) at no charge after a $5 office visit copayment. When you enroll in a DeltaCare USA1 plan, you’ll choose a primary care dentist from our network of carefully screened, private practice dentists. DeltaCare USA DHMO, focuses on maintaining oral health, prevention and cost containment. $25 ($75 for out-of-network care) per person … Understanding orthodontic benefits for DeltaCare® USA plans Orthodontics is a dental specialty dedicated to diagnosing, preventing and treating malocclusion (improper alignment of biting or chewing surfaces of upper and lower teeth) through braces, corrective procedures and other appliances to straighten teeth and correct jaw alignment. It's easy to look up your benefits online, including your dentist network, maximums and deductibles, copayment percentage for standard and orthodontic coverage, and other details. H0524_19SB003_M PBP 003 60872209 S 003 January 1–December 31, 2019 . Option 2 is a DeltaCare® USA dental HMO program provided by Delta Dental of California and administered by Delta Dental Insurance Company. Yes, your DeltaCare USA plan provides coverage for accidental injury (caused by external forces) at 100% of the contract dentist’s “filed fees” for benefits (less any applicable copayments). Enrollees should obtain an estimate from their orthodontist prior to beginning treatment. These plans are designed to address the growing demand by DeltaCare USA members for dental implants. In Florida, Delta Dental Insurance Company provides DeltaCare USA Plan benefits as a Prepaid Limited Health Service Organization as described in Chapter 636 of the Florida Statutes. Dependent children include natural children, step-children, adopted children, children placed for adoption and children of a Spouse. Benefits to Help You Explore Tomorrow. Is general anesthesia/intravenous sedation covered? How do enrollees begin orthodontic treatment? Previous post Dentist spotlight: Dr. Zahra L. Hosseini Next post Loan program expires December 31 Search posts. 1333 0 obj <>/Encrypt 1318 0 R/Filter/FlateDecode/ID[<9CC208CC139F1044916BF2D4E9EC3E41><102EE38D78AA954287CC2A5DB3B5C3A8>]/Index[1317 50]/Info 1316 0 R/Length 98/Prev 875363/Root 1319 0 R/Size 1367/Type/XRef/W[1 3 1]>>stream DeltaCare® USA Dental benefits the easy way Underwriter Delta Dental of California 17871 Park Plaza Drive, Suite 200 Cerritos, CA 90703 Claims and Correspondence P.O. Dental. To find a DeltaCare USA dentist, enrollees can go to Online Services and search for a DeltaCare USA dentist by specialty and location using the Find a Dentist tool. † The DeltaCare USA program typically covers all types of orthodontics: Limited orthodontics for children and adults, interceptive orthodontics for children and comprehensive orthodontics for children and adults.*. benefits DeltaCare USA implants. When you enroll, you select a contract dentist to provide services. DeltaCare® USA DHMO Plan . Here is an example of the effective dates based on plans: When does coverage become effective? A prepaid plan requires you and your eligible dependents to use a dentist from a specific list of dentists who are located in California and who contract with your selected prepaid carrier. DeltaCare® USA Dental benefits made easy! Under the DeltaCare® USA program, many services are covered at no cost, while others have copayments (amount you pay your contract dentist) for certain benefits. DeltaCare USA is Delta Dental’s dental HMO, which offers low-cost dental coverage with a focus on preventive care. Enrollees can read this Box 1803 Alpharetta, GA 30023 800-471-9925 deltadentalins.com CoveredCA.com 800 … Every DeltaCare USA enrollee is mailed a Combined Evidence of Coverage and Disclosure Form (EOC) booklet within 30 days of enrollment as part of a welcome packet that also includes ID cards. DeltaCare® USA Dental benefits made easy! File Size 324.99 KB. Details. DeltaCare ® USA plan. Password? The primary care dentist coordinates specialty care needs for oral surgery, pediatric dentistry, endodontics or periodontics with a DeltaCare USA network specialist. Can enrollees find out how much orthodontic treatment will cost? DeltaCare USA, Premier Access, SafeGuard, and Western Dental The prepaid plans require you and your eligible dependents to use a dentist from a specific list of dentists who are located in California and who contract with your selected prepaid carrier. Refer to your benefit plan to determine whether preventive services are covered for you. DeltaCare ® USA (Dental HMO; California residents only) This plan provides comprehensive benefits and easy referrals to specialists. DeltaCare® USA (DHMO) Under the DeltaCare® USA program, many services are covered at no cost, while others have copayments (amount you pay your contract dentist) for certain benefits. DeltaCare® USA Dental benefits the easy way Underwriter Delta Dental of California 17871 Park Plaza Drive, Suite 200 Cerritos, CA 90703 Claims and Correspondence P.O. You may request electronically a list of your benefits by submitting the online Customer Service Request for DeltaCare USA. Dental benefits can help pay for you and your dependents dental expenses. Dental services that are not performed by your selected in-network participating (contracted) dentist, or are not covered under provisions for emergency care below, must be … Enjoy minimal or no copayments for preventive care and choose from a network of dentists to manage your dental needs. In most states, enrollees must select a primary care dentist in the DeltaCare USA network in order to receive treatment, as in a traditional HMO. For a complete description of the details of your coverage, please refer to your coverage documents. DeltaCare® USA (DHMO) Under the DeltaCare® USA program, many services are covered at no cost, while others have copayments (amount you pay your contract dentist) for certain benefits. If enrollees cannot reach their network dentist or DeltaCare USA customer service for a referral, they may use their out-of-area emergency benefit (typically limited to $100 per emergency, subject to standard plan limitations and exclusions; copayments may apply). When you enroll, you select a contract dentist to provide services. Main page content Document File(s) DeltaCare Benefits Guide. DeltaCare USA Continuous Orthodontic Coverage form29 KB from the Delta Dental Review your group contract for specific details regarding coverage under your plan. DeltaCare USA, Premier Access, SafeGuard, and Western Dental. by your selected DeltaCare USA Contract Dentist. For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website. The plan emphasizes preventive care, so many services are provided at no cost. You must be a resident of California to enroll. Are pre-existing dental conditions and treatment-in-progress covered? DeltaCare® USA DENTAL COMPARISON CHART Effective September 1, 2019 State of Texas Dental Choice This is a preferred provider organization (PPO) dental insurance plan. Document Type application/pdf. Dental Medicare Member Portal . DeltaCare USA plan features •No deductibles, no Clearly defined copayments • No annual deductibles and no maximums • Low or no costs for many services such . Document Description . under your plan. Understanding orthodontic benefits for DeltaCare® USA plans Orthodontics is a dental specialty dedicated to diagnosing, preventing and treating malocclusion (improper alignment of biting or chewing surfaces of upper and lower teeth) through braces, corrective procedures and other appliances to straighten teeth and correct jaw alignment. Contact. Welcome to your DeltaCare USA plan! Plus, earn a $100 statement credit after you make a Delta purchase with your new Card within your first 3 months. Effective Date January 1, 2019 Benefit Period January 1, 2019 – December 31, 2019 Benefit Period Maximum No Maximum Benefit Period Deductible No Deductible Orthodontia . Upon enrollment, enrollees will receive a plan booklet with defined copayments for covered services. See the "Limitations and Exclusions of Benefits." Adult & Children • $ 1,150 - $1,900 copay for children to age 19. • Explanation of Benefits showing how much the previous plan has paid to date and amount remaining. Once enrollees start treatment they cannot switch orthodontists. With our Online Services, it’s simple for your DeltaCare USA enrollees to maximize their plan. Yes, with a referral from the child’s assigned general dentist. If you or an eligible member of your family has © Delta Dental This website is the home of Delta Dental of California; Delta Dental Insurance Company; Delta Dental of Pennsylvania; Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; Delta Dental of West Virginia, Inc. and their affiliated companies. The DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. The information below applies to our standard processing policies and contract coverage, and is to be used only as a guide. Benefit Summary . 0 How do enrollees select or change their general dentist? Enjoy minimal or no copayments for preventive care and choose from a network of dentists to manage your dental needs. Enrollees should obtain a detailed treatment plan with all procedures and costs when visiting their orthodontist for the first time. Share … Footer menu. DeltaCare USA for Small Businesses Group Name Group No. No. At the time of service, enrollees pay the dentist only the listed copayment (found in their plan booklet) for covered services. Welcome to DeltaCare DeltaCare is an innovative dental plan that provides you with comprehensive care at a significantly lower cost than most other dental plans—which means great value for you. Release Date. Estimates may vary depending on your benefit plan and the state you live in. How to use the DeltaCare USA Plan – Choice of Contract Dentist To enroll in this Program, you … Does the plan cover extractions for orthodontic purposes? Plan Benefits. Refer to your group contract to determine if this coverage is included with your plan. Enrollees should download the Most basic services are covered at no cost. Treatment for pre-existing conditions, such as extracted teeth, is covered under the DeltaCare USA program. Adult Enrollees eligible for Adult Benefits are:  a Primary Enrollee 19 years of age or older; and/or  a age 19 to age 26. Wellness For more information on the i-series plans, please consult your DeltaCare USA benefits book. Username or Once redeemed, Choice Benefits cannot be exchanged or replaced. Instead, you receive up to 25% off the full cost for those services. DeltaCare USA Continuous Orthodontic Coverage form. Box 1810 Alpharetta, GA 30023. Each … Read more + less - † $250 Annual Fee. for enrollees. e-magazine However, benefits are not provided for any dental treatment-in-progress started before joining the program (such as teeth prepared for crowns, root canals and impressions for dentures). DeltaCare® USA Dental benefits made easy! When you enroll in a DeltaCare USA1 plan, you’ll choose a primary care dentist from our network of carefully screened, private practice dentists. The orthodontist will complete the form and mail it to our DeltaCare USA Claims department, along with the required supporting documents. Preventive services are included in this tool. Most basic services are covered at no cost. Enrollees can simply provide the dentist with their name, date of birth and social security number or enrollee ID to verify coverage, or they can display ID cards from their mobile device by logging in to Online Services. Enrollees are responsible for the listed copayment. (Some orthodontists may refer patients to labs specializing in orthodontic x-rays for specific photos.) Treatment-in-progress coverage depends on your plan and applies only if enrollees are in active treatment (banding has taken place). Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. The DeltaCare USA network consists of private practice If you or an eligible member of your family has You must be a resident of California to enroll. Kaiser Permanente Senior Advantage Los Angeles and The DeltaCare USA plan provides you with quality dental benefits at an affordable rate and is designed to encourage you to visit the dentist regularly to maintain your dental health. %%EOF Tuesday, October 1, 2019. Plan Benefit Summaries. (States are rated and approved for each group. Box 1803 Alpharetta, GA 30023 844-697-0578 Created with Sketch. Do enrollees’ dependents receive treatment from the same primary care dentist? Delta Dental/DeltaCare USA/Plan 10A – Plan 15B, Plan 48N. DeltaCare USA is a managed dental care plan. Your group contract serves as the controlling document of your plan. Yes. DeltaCare USA program. Family members may select their own DeltaCare USA general dentist in approved states. Follow our simple, three-step registration process and log in to our secure system to see your eligibility information and benefits details. For a more targeted search, enrollees can enter the name of a dentist or dental office. General information regarding your dental benefits. General information regarding cost estimates. Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. register for Online Services. UT … The DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. These networks are generally quite small. No. There are no yearly maximums or deductibles. However, benefits are not provided for any dental treatment started before joining the program (that is, work in progress, such as preparations for crowns, root canals and impressions for dentures). When you enroll in a DeltaCare USA1 plan, you’ll choose a primary care dentist from our network of carefully screened, private practice dentists. You may request electronically a list of your benefits by submitting the online Customer Service Request for DeltaCare USA. Under the DeltaCare® USA program, many services are covered at no cost, while others have copayments (amount you pay your contract dentist) for certain benefits. These benefits are neither offered nor guaranteed under a contract with the Federal Employees Health Benefit (FEHB) Program, but are made available to all enrollees and family … You must visit your selected DeltaCare USA general dentist to receive benefits . They can visit the same orthodontist, with the same coverage and copayments as their previous plan as long as they remain eligible for coverage under their DeltaCare USA plan.*. Box 1810 Alpharetta, GA 30023. Under the DeltaCare® USA program, many services are covered at no cost, while others have copayments (amount you pay your contract dentist) for certain benefits. Q+A: Continuous Orthodontic Coverage with your DeltaCare USA Plan. Enrollees should discuss all treatment options with … Responsible Office(s) Employee Benefits. Orthodontic treatment in progress may be covered for new DeltaCare USA enrollees. DeltaCare USA, Premier Access, SafeGuard, and Western Dental The prepaid plans require you and your eligible dependents to use a dentist from a specific list of dentists who are located in California and who contract with your selected prepaid carrier. This document is a combined Evidence of Coverage and Disclosure Form for your Dental HMO Program. Phone (800) 893-3582. Plan CAD48 DeltaCare USA Description of Benefits and Copayments SCHEDULE A Description of Benefits and Copayments The Benefits shown below are performed as deemed appropriate by the attending Contract Dentist subject to the limitations and exclusions of the Program. Orthodontic treatment-in-progress may be covered for new DeltaCare USA enrollees. When you enroll, you select a contract dentist to provide services. DeltaCare USA (administered by Delta Dental Insurance Company) provides you and your family with quality dental benefits at an affordable cost. Offered through Delta Dental Insurance Company, the DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to … CoPower Select. DeltaCare USA (administered by Delta Dental Insurance Company) provides you and your family with quality dental benefits at an affordable cost. The plan emphasizes preventive care, so many services are provided at no cost. Date Published December 6, 2018. UUP Benefit Trust Fund DeltaCare USA (DHMO) Enrollment Card United University Professions, PO Box 15143, Albany, NY 12212-5143 www.uupinfo.org 800-887-3963 (Phone) or 800-559-0516 (Fax) Please be sure to choose a DeltaCare USA Primary ntist or one will be assigned to you. No. DELTACARE USA Managed care option—all dental care must be coordinated through your network dentist DELTA DENTAL PPO To receive the highest level of benefits, use Delta Dental PPO dentists NATIONWIDE NONE KNOW YOUR OPTIONS BEFORE YOU CHOOSE GLOSSARY — Here’s a key to the abbreviations you’ll see throughout this summary chart. endstream endobj startxref To receive orthodontic benefits, enrollees begin by selecting a DeltaCare USA network orthodontist. The DeltaCare USA network gives enrollees plenty of options if they need to visit a specialist (their primary care dentist will help coordinate care). Footer menu. DeltaCare ® USA (Dental HMO; California residents only) This plan provides comprehensive benefits and easy referrals to specialists. You can see any dentist you want, but will pay less if you go to a dentist in one of the two Delta Dental networks: • Delta Dental PPO • Dental Premier Dentists of both the Delta Premier and Delta Dental PPO are in … Open Enrollment Information and Comparison Guide 4 2019 Employee Benefits PLAN NAME DELTA DENTAL Premier Plan (PPO) DELTACARE - PLAN (HMO) MEMBER SERVICES Participating Dentist PLAN PAYS: Non-Participating Dentist Plan pays up to 70% of maximum plan allowance: FEE CROWNS AND BRIDGES: (4): CROWNS - PER UNIT 70% Up to 70% No Cost These plans will include coverage for all major codes related to the placement and removal of dental implants and abutments. Preventive care coverage varies by plan and by demographic considerations such as age. You must use network providers and choose a primary care dentist (PCD). DeltaCare USA Plan 11A (Spanish).pdf . It offers a wide range of benefits for specialty referrals when you are referred by your participating general dentist. Getting affordable dental coverage is easier than ever with a DeltaCare USA¹ plan. (In most states, if they do not select a primary care dentist, Delta Dental will assign one near the enrollee’s home address.). Download. Before enrolling, make sure that the dentist you wish to see is in this plan's network. In Florida, Delta Dental Insurance Company provides DeltaCare USA Plan benefits as a Prepaid Limited Health Service Organization as described in Chapter 636 of the Florida Statutes. Dentist changes made by the 21st of the month will take effect on the first of the following month. Username or DELTACARE USA (Managed care option) 50% coverage up to $2,000 per child to age 26 (lifetime) for in-network care ($1,500 for out-of-network care) EMERGENCY TREATMENT, PALLIATIVE (TO RELIEVE PAIN) PREDETERMINATION OF BENEFITS BASIC COVERAGE MAJOR COVERAGE ORTHODONTIA DENTAL ACCIDENT PREVENTIVE COVERAGE You pay a fixed copay for a standard 24-month course … Offered through Delta Dental Insurance Company, the DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. DeltaCare USA (administered by Delta Dental Insurance Company) provides you and your family with quality dental benefits at an affordable cost. Plan CAD48 DeltaCare USA Description of Benefits and Copayments SCHEDULE A Description of Benefits and Copayments The Benefits shown below are performed as deemed appropriate by the attending Contract Dentist subject to the limitations and exclusions of the Program. >> Benefit Eligibility Note: • All M-DCPS groups are eligible to enroll in the DeltaCare USA (DHMO) offered by the School Board. Their copayments, limitations and exclusions are determined by the group contract.*. How do enrollees find a contracted DeltaCare USA orthodontist? Welcome to your DeltaCare USA plan! • Explanation of Benefits showing how much the previous plan has paid to date and amount remaining. Dentists receive a flat fee for each member assigned to their offices. DeltaCare USA, Premier Access, SafeGuard, and Western Dental. Enrollees can search for a dentist using the Find a Dentist feature on the right side navigation on Orthodontic coverage is available to adults and children. Web features for DeltaCare USA enrollees. Created with Sketch. Enrollees must be eligible under their DeltaCare USA plan when the accident occurs. Welcome to DeltaCare USA — quality, convenience, predictable costs DeltaCare USA (administered by Delta Dental Insurance Company) provides you and your family with quality dental benefits at an affordable cost. For more information about your dental benefits, visit the Delta Dental Medicare Member Portal below. Coverage of implants means you have another tool in your toolbox when it comes to recommending the best treatments for your patients. Document Type. Q+A: Continuous Orthodontic Coverage with your DeltaCare USA Plan. DeltaCare Benefits Guide. If there is no network specialist within the service area, a referral to an out-of-network specialist will be authorized at no extra cost, other than applicable copayments. The DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. DeltaCare USA program. Manage your enrollment and view eligibility and benefits. Refer to your group contract to determine if this coverage is included with your plan. A prepaid plan requires you and your eligible dependents to use a dentist from a specific list of dentists who are located in California and who contract with your selected prepaid carrier. >> Benefit Eligibility Note: • All M-DCPS groups are eligible to enroll in the DeltaCare USA (DHMO) offered by the School Board. Created with Sketch. enrollees web page and give it directly to their orthodontist. Earn 40,000 bonus miles and 5,000 Medallion Qualification Miles (MQMs) after you spend $2,000 in eligible purchases on your new Delta SkyMiles® Platinum American Express Card within your first 3 months. flyer1.3 MB for more help on finding a network dentist. 2019 Summary of Benefits . deltadentalins.com. Invisalign and other specialty appliances will result in additional fees. Exceptions for medical conditions, regardless of age limitation, will be considered on an individual basis. Forgot The DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. To select or change their assigned general dentist, enrollees must INFORMATION CONCERNING BENEFITS UNDER THE DELTACARE USA PROGRAM THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. 2019 Summary of Benefits (SOB) DeltaCare USA DHMO. General information regarding your dental benefits. When you enroll, you select a contract dentist to provide services. Enrollees should compare the treatment plan with their benefit booklet and to be sure to ask the orthodontist any questions they have before receiving care. All treatment plans are different. Choice Benefit selections for 2020 Status need to be made by January 31, 2021; selections for 2021 Status need to be made by January 31, 2022. Here is an example of the effective dates based on plans: When does coverage become effective? DeltaCare USA is a dental program that provides you and your family with quality dental benefits at an affordable cost. Password? Before you enroll, make sure there is a DHMO network dentist in your area. Related. DeltaCare works much like a dental HMO, in which you and your family receive all your care from a network of partici Copays do not apply to services received from participating specialty dentists. Kaiser Permanente Senior Advantage Los Angeles and Website. The DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. 1317 0 obj <> endobj DeltaCare USA Plans - DHMO Dental Plans. Please refer to Schedule B for further clarification of Benefits. In most states, you must visit your selected network dentist in order to receive plan benefits. Delta Dental plans and features. Enrollees should discuss all treatment options with … THE COMBINED EVIDENCE OF COVERAGE AND DISCLOSURE FORM AND THE PLAN CONTRACT SHOULD BE CONSULTED FOR A DETAILED DESCRIPTION OF COVERAGE BENEFITS AND LIMITATIONS. All x-rays must be performed by the orthodontist. DeltaCare® USA (DHMO) Click to play Dental Video: Healthy Tip: Preschedule your next dental appointment at the end of your dental visit to maintain routine treatment for yourself and your family members. Dentists receive a … DeltaCare USA is a closed network product* that features set copayments, no annual deductibles and no maximums for covered benefits. Please refer to Schedule B for further clarification of Benefits. Enrollees must receive care from their selected/assigned primary care dentist within the DeltaCare USA network. Treatment they can not switch orthodontists copayments, no annual deductibles and no maximums for covered.! An eligible member of your benefits by submitting the online Customer Service 888-282-9501 deltadentalins.com Delta dental California! This document is a dental program that provides you and your family with quality dental benefits, the! Usa contract dentist to provide services benefits book cover extractions for orthodontic purposes at the listed copayment member below! Than ever with a referral from the drop-down menu coverage documents dentist to benefits. 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Appliances will result in additional fees referrals when you enroll, you select a contract to. Coverage become effective in most states, you must visit your selected DeltaCare USA a. Coverage for all major codes related to the placement and removal of dental implants and.! These plans will include coverage for all major codes related to the placement and removal of dental and. Procedures and costs when visiting their orthodontist for the covered services than ever with a USA!, earn a $ 100 statement credit after you make a Delta purchase with your DeltaCare USA is a network... $ 2,100 copay for adults * that features set copayments, no annual deductibles and no maximums for covered.... Participating general dentist in approved states has paid to date and amount remaining about your dental health a. In approved states treatment from the Provider Tools Reference Library on our.... 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