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. Password? The primary care dentist coordinates specialty care needs for oral surgery, pediatric dentistry, endodontics or periodontics with a DeltaCare USA network specialist. Enjoy minimal or no copayments for preventive care and choose from a network of dentists to manage your dental needs. DeltaCare works much like a dental HMO, in which you and your family receive all your care from a network of partici Their copayments, limitations and exclusions are determined by the group contract.*. Welcome to your DeltaCare USA plan! Registration is easy – the three-step process takes just a few minutes. Invisalign and other specialty appliances will result in additional fees. Orthodontic treatment in progress may be covered for new DeltaCare USA enrollees. Most basic services are covered at no cost. DeltaCare USA Continuous Orthodontic Coverage form. General information regarding your dental benefits. ��I>�6'1�ۖJ��I|&&u���|�|~X���H�݁��V.�l���,�����a,��S�?2�����>��p���|F�|\g㖿i���@�W`�,�廷�j�yi)���pjx~x���p����y��B��� I�. Refer to your benefit plan to determine whether these requirements apply to you. For a complete description of the details of your coverage, please refer to your coverage documents. General information regarding cost estimates. DeltaCare USA is a dental program that provides you and your family with quality dental benefits at an affordable cost. DeltaCare USA, Premier Access, SafeGuard, and Western Dental. 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. For more information on the i-series plans, please consult your DeltaCare USA benefits book. 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. 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. Enrollees must be eligible under their DeltaCare USA plan when the accident occurs. Dental. DeltaCare USA (administered by Delta Dental Insurance Company) provides you and your family with quality dental benefits at an affordable cost. (States are rated and approved for each group. Follow our simple, three-step registration process and log in to our secure system to see your eligibility information and benefits details. The plan emphasizes preventive care, so many services are provided at no cost. Are pre-existing dental conditions and treatment-in-progress covered? Exceptions for medical conditions, regardless of age limitation, will be considered on an individual basis. The DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. Box 1803 Alpharetta, GA 30023 844-697-0578 Review your group contract for specific details regarding coverage under your plan. Mail to: DeltaCare USA Claims Department P.O. See the "Limitations and Exclusions of Benefits." Benefit Highlights; DeltaCare USA Enrollees: DeltaCare USA is our closed-network plan. When you enroll, you select a contract dentist to provide services. 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). Estimates may vary depending on your benefit plan and the state you live in. DeltaCare USA (administered by Delta Dental Insurance Company) provides you and your family with quality dental benefits at an affordable cost. Enrollees are responsible for the listed copayment. Dentists receive a flat fee for each member assigned to their offices. Visit your DeltaCare USA dentist. 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 If any services are provided by a non-DeltaCare USA Contract Dentist or specialist, you will be obligated to pay for such services. Related. Benefit Summary . DeltaCare® USA DHMO Plan . DeltaCare USA is a dental program that provides you and your family with quality dental benefits at an affordable cost. 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. You may request electronically a list of your benefits by submitting the online Customer Service Request for DeltaCare USA. 2019 Summary of Benefits (SOB) DeltaCare USA DHMO. CoPower Select. Enrollees must enter their location and select the DeltaCare USA network from the drop-down menu. 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. Enrollees must receive care from their selected/assigned primary care dentist within the DeltaCare USA network. You must be a resident of California to enroll. Manage your enrollment and view eligibility and benefits. 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. 0 Plan Benefit Summaries. Is general anesthesia/intravenous sedation covered? under your plan. Download. H0524_19SB003_M PBP 003 60872209 S 003 January 1–December 31, 2019 . Details. When you enroll in a DeltaCare USA1 plan, you’ll choose a primary care dentist from our network of carefully screened, private practice dentists. To receive orthodontic benefits, enrollees begin by selecting a DeltaCare USA network orthodontist. DeltaCare USA Plans - DHMO Dental Plans. Much like medical HMOs, dental maintenance organizations require that you receive all of your dental care from a limited network of contracted dental offices. No. Created with Sketch. 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.