It can be hard to get a word in between the cleaning procedures when you’re at the dentist, but it’s important for you to speak up. Asking questions about procedures and your oral health is important for your wellbeing and pocketbook.
Q&A – Members
1. What is a dental plan?
Understanding your dental benefits can help you get appropriate and cost-effective care. Visit the Understand your Dental Benefits page for more information.
2. Do I need my identification (ID) card when I get care?
If you have an ID card, show it to your dentist at each visit so a proper claim can be filed for your dental services. You can get replacement ID cards by logging into Delta Dental’s secure member portal.
3. What if someone in my family has another dental insurance plan? How does COB (Coordination of Benefits) work?
When someone has additional dental coverage, one plan is usually primary. Your dentist will send the claim for service to the primary insurance plan and may also submit it to a secondary plan. In this case, Delta Dental will coordinate benefits. Refer to your benefit booklet for your plan’s specific provisions.
5. How do I know which dentist to select?
Ask friends, neighbors, co-workers and family to find a dentist who matches your needs and values. A convenient location and clinic hours, possibly including Saturday and evening hours, may also be important considerations.
6. Do I need to verify that my dentist is a Delta Dental participating dentist?
Yes. By checking with your dentist or Delta Dental Customer Service (see the back of your ID card for the phone number), you are assured that your dentist is still participating in the network. Consult your benefit booklet for more information regarding your specific plan design. We suggest you verify a dentist’s participation status with Delta Dental or your dental office before each appointment.
- A Delta Dental participating dentist has signed a participating and membership agreement with Delta Dental.
- The dentist has agreed to accept our allowable charge as payment in full for covered dental care. A participating dentist is not allowed to bill more than our allowable charge.
- A Delta Dental participating dentist will also file the claim directly with us. We will make payment directly to the participating dentist and you will receive an explanation of benefits detailing your financial responsibility for any deductible or coinsurance amounts.
- Reimbursement for the services will be paid directly to you, and you are responsible for paying your dentist.
- The allowances for services you receive from a non-participating dentist may be significantly less than what Delta Dental would pay a Delta Dental participating dentist. You may share more of the cost of your care and are responsible for the dental charges up to the dentist’s full-billed amount.
9. What username should I use when signing into the system?
Use the username you created during the registration process. Note, the username field is separate from the subscriber ID field, which uses your subscriber ID or social security number.
10. Who do I contact with a change of address?
If you have dental benefits through your employer, report your new address to your employer. Your employer will forward your address change to us. When visiting your dentist, make sure they have your correct address to use when submitting claims. If you purchased a plan from us, contact customer service via the number on the back of your ID card.
11. How are dental benefits affected if my dependent child is ill or injured and can no longer attend school on a full-time basis?
Under Michelle’s Law, if an unmarried dependent child who was attending a postsecondary educational institution on a full-time basis and is currently covered under the parent’s dental benefit policy becomes seriously ill or is injured, he/she may continue to be covered. In order to remain covered, a physician must provide written documentation supporting the need for a medical leave. For details: