In fact, you aren’t required to designate a primary care dentist when enrolling in a PPO dental plan. Periodic Oral Exam Once every 6 … A Premier dentist will still give you discounted fees and the largest network of dentists from which to choose. One time per person. Use the Find A Dentist tool on our website or on the mobile app to search for dentists by city and network. Delta 1300 Monthly premium starts at $40.24 Enroll Now. Annual Maximum Benefit. Future rates are subject to change at a 2-9 Enrolled Employees Benefit Summary . You can easily find a dentist now in the Delta Dental networks. More than four out of five dentists nationwide are participating Premier ™ dentists. Employer Contribution. In addition, most PPO dental plans have an annual limit on the amount of coverage . $1,500. Delta Dental PPO Plus Premier Delta Dental PPO Plus Premier Delta Dental PPO Standard Delta Dental PPO Standard Network Type PREMIUMS (Based on home ZIP code) Each plan includes the pediatric dental benefit as required by the Affordable Care Act. Calendar Year Maximum: $1,500 per person. Under this program, you may use any dentist you wish. You don’t have to pay the entire bill and wait for reimbursement. DELTA DENTAL PPO PLUS PREMIER - COMPREHENSIVE ENHANCED with Orthodontic Coverage Dental Benefit Plan Summary South Washington County Schools Group Number 6049 . The information provided on this site is for general education purposes only and is not intended as a diagnosis, treatment, or a substitute for professional medical or dental advice, diagnosis, or treatment. 50%. In that case, you would be responsible for any applicable coinsurance (though many plans cover diagnostic and preventive services at 100%) or additional charges when visiting a non-network dentist. Yes. * Not sure where your company is headquartered? After a visit to the dentist, you may receive an Explanation of Benefits, or EOB. This sheet provides a brief description of important features of the Delta Dental PPO plus Premier dental program. No matter which Delta Dental network the dentist is in, you’ll get the same great advantages of having a Delta Dental of South Dakota plan: Copyright © 2021 Delta Dental of South Dakota. Generally, Delta Dental PPO TM and Delta Dental Premier ® plans have deductibles, but DeltaCare ® USA, our prepaid, fixed copayment plan, does not. 100%. These dentists have agreed to contracted fees with Delta Dental, so for covered services, you pay no more than your copay and deductible. 10. Yes. Delta Dental PPO TM Generally, Delta Dental PPO and Delta Dental Premier plans have maximums and deductibles, but the DeltaCare USA plan does not. Delta Dental PPO plus Premier; Delta Dental PPO (or Delta Dental Premier) Delta Dental PPO Choice; If your ID card shows one of these plans, you may visit a Delta Dental Premier dentist and your benefits will be covered. No balance billing. $42.25 on 2/1/21. When you have a family deductible, the individual deductible applies per person until the family deductible amount is reached. Learn more about maximums. Delta Dental network dentists handle all claim forms and other paperwork, so there is less work for you. With Delta Dental PPO plus premier, you have the benefit of choosing a dentist from either the PPO or Premier network. All Rights Reserved. CompEnhEHBJun2014 DENTAL BENEFIT PLAN SUMMARY This is a Summary of your Group Dental Program (PROGRAM) prepared for Covered Persons with: South Washington County Schools (GROUP) This Program has … When you visit a non-Delta Dental dentist, you’re responsible for any amount the dentist charges above our allowance for that service. Plan Highlights. PPO™ Premier® and Out-of-Network: Calendar Year Deductible Per person/per family (excluding Preventive and Diagnostic) $50/$150: Calendar Year Maximum (Per enrollee) $1,500 | $1,000: Waiting Period None: Orthodontics Not covered *Members will be subject to balance billing for covered services. 2Delta Dental dentists agree to our determination of fees and won’t bill you more than your share of Delta Dental’s approved fee for a covered service. This program features two levels of claims savings. The information provided on this site is for general education purposes only and is not intended as a diagnosis, treatment, or a substitute for professional medical or dental advice, diagnosis, or treatment. $1,200 . Enrolled members get a broad choice of dentists in two networks and lower out-of-pocket costs. That gives you a lot of choices, and you’ll still get discounts for services. Find a dentist Dual Network Safety Net. Finding a dentist in our Premier and PPO networks is easy. Ask your dental office for your plan’s deductible information. If you do not have State of Wisconsin group health coverage and therefore are not enrolled in the UDB plan, you have the option to enroll in this supplemental preventive plan. Call our interactive voice response telephone line. Annual Maximum Benefit. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. You can also find your plan information when you login to your account online or on the mobile app by looking under Benefits & Eligibility. However, your out-of-pocket costs may be lower when you select a dentist who participates with Delta Dental. PPO Plus Premier All voluntary group plans are Delta Dental PPO Plus Premier plans. Or call us at 877-841-1478; we're happy to help you. In addition, Delta Dental PPO and Delta Dental Premier® dentists will submit claims directly to Delta Dental and we will issue the payment to the dentist. Get assistance in a language other than English, Viewing your eligibility information online, Finding your Delta Dental plan information, Beware of offers to waive coinsurance amounts, Go Paperless: Access Your Statements Online, Adding a spouse or dependent to your plan, Mobile Online Services – your ID card and benefits on the go, Amount Plan Pays — 80% of $150 (balance after deductible is paid), Remaining Balance (after you pay the deductible and the plan payment is calculated). $50 annual deductible (per person) for all Delta Dental Select plans. Once you enroll, you’ll get coverage for diagnostic and preventive care, including exams, cleanings and x-rays. Contact your company's human resources department. What if my dentist is in the Premier network? You will receive the greatest out-of-pocket savings if you see a Delta Dental PPO provider. Delta Dental PPO Plus Premier Coverage Summary for Smithsonian Astrophysical Observatory Deductible: $50 per individual I $150 per family. None. There are three ways to check the amount of your remaining deductible: 1Refer to your plan booklet or Policy for more information about covered services, deductibles and maximums. Yes. … 75%. Our PPO Plus Premier plans give you the same broad access to dentists in the Delta Dental Premier network, PLUS the opportunity to save even more when you visit a dentist in the Delta Dental PPO network. Delta Dental gives you an added benefit other carriers can't — our dual network safety net. However, you will receive the greatest out-of-pocket savings if you see a Delta Dental PPO provider. አማርኛ       Français       Srpsko-hrvatski       中文       Deutsche       नेपाली       한국어       Adamawa       Oromiffaa       Русский       Español       Tagalog       Українська       Tiếng Việt, I have dental insurance through my employer. This option offers an added advantage to patients receiving treatment from a Delta Dental PPOSM Provider. When your dentist submits a claim for a service, your deductible is applied first, and then any coinsurance is calculated. Added benefits for those at high risk of tooth decay or gum disease. Deductible Note. PPO Plus Premier 5 BA With a $75/$225 Deductible and $1,500/$1,000 Calendar Year Maximum Download. Benefits Per person per calendar year. PPO Plus Premier™ 3. If you have a PPO Plus Premier plan and visit a dentist in our PPO network, you may have lower out-of-pocket costs. Delta Dental PPO plus Premier Network. 100/100/60 PPO Plus Premier 5 AA With a $50/$150 Deductible and $1,500/$1,000 Calendar Year Maximum Download. PPO™ Premier® and ; Out-of-Network: Calendar Year Deductible: Per person/per family (excluding Preventive and Diagnostic) $50/$150: Calendar Year Maximum (Per enrollee) $1,500 | $1,000 Waiting Period : None Orthodontics: Not covered *Members will be subject to balance billing for covered services. Non-Par . We offer two base plan options that differ only in how non-Delta Dental PPO dentist reimbursement is calculated: Delta Dental PPO and Delta Dental PPO plus Premier 43 KB. If you are considering a PPO dental plan, keep in mind that you’ll pay a higher premium and will likely be required to meet a deductible. $1,200. 25%. $1,200. We'd be happy to visit with your dentist about joining our PPO network. Connect with your Delta Dental to learn more. Plan Highlights. For single premium. As a Delta Dental PPOPlus PremierIncented Voluntary Planmember, you benefit from having access to two of Delta Dental’s extensive national networks— Delta Dental PPO, more than 193,000 participating dentist locations and Delta Dental Premier, the largest dental network in the country with more than 278,000 dentist locations. Monthly rates for all plans valid 1-1-20 through 12-31-20. Delta Dental PPO Plus Premier™ Delta Dental PPO Plus Premier combines the Delta Dental PPO and Delta Dental Premier networks, which gives you the benefits of Delta Dental PPO and more. Rates are effective January 1, 2020 – December 31, 2020. Maximum Bonus Account. Deductible. Health through Oral Wellness. Consult your dentist or physician for information or treatment specific to you and your health. Delta Dental PPO Plus Premier ™ Flexibility and value, times two. For single premium. Does not apply to Diagnostic, Preventive, or Orthodontic Services. Advantages of the Delta Dental PPO Plus Premier Plan: It pays to use Delta Dental network providers — especially those in our PPO network. No. What if your dentist isn’t a Delta Dental dentist? $25, not to exceed $75 per family. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. Contact our Professional Relations team at 800-627-3961 or delta.prof@deltadentalsd.com to refer us to your dentist. PPO Plus Premier 5 AB With a $50/$150 Deductible … DeltaCare USA: Network for most group plan enrollees, DeltaCare USA Individual: Network for Individual plan enrollees (CA only), DeltaCare USA Medicare: Network for Medicare Advantage plan enrollees (CA only), DeltaCare USA Connect: Network available only to enrollees in select southern California groups. Non- s full payment. Benefit Summary . 1 Plus the premium plan also includes specialty coverage for implants, crowns and root canals. Delta Dental of South Dakota is a part of the Delta Dental Plans Association. For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website. A minimum of two subscribers must be enrolled in either Delta Dental PPO, PPO - Plus Premier and/or - Plus Premier “Elite” plans. Delta Dental PPO Individual Premium Plan is a plan that covers a percentage of your costs for covered dental services. Beginning February 1, 2021, monthly premiums will start at $17.00. At that point, the family deductible is considered to be met. Our PPO Plus Premier plans give you the same broad access to dentists in the Delta Dental Premier network, PLUS the opportunity to save even more when you visit a dentist in the Delta Dental PPO network. Category I Procedure I Qualifications Diagnostic Comprehensive Evaluation Once every 60 months per dentist. Minimum of 2 employees enrolled. Per person per calendar year. 6 This not only gives you a great selection of qualified dentists to choose from, but increases the likelihood that your dentist already participates in the network. Have a question about coverage or looking for dental insurance? A way to save . Read Your Dental Plan Description Carefully—This Outline of Coverage provides a very brief description of the important features of your dental benefits plan. The Delta Dental PPO Plus Premier – Preventive Plan mimics UDB coverage. Employee Enrollment % Required. Delta Dental PPO and Delta Dental Premier® required coinsurance and deductible (if applicable) as payment in full. PPO Plus Premier™ 5 2-9 Enrolled Employees. In addition, Delta Dental PPO and Delta Dental Premier® dentists will submit claims directly to Delta Dental and we will issue the payment to the dentist. Participating dentists agree to accept our payment and your co-insurance or deductible (if applicable) as full payment. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. This part of your out-of-pocket costs is known as “coinsurance.” Delta Dental PPO … Minimum Employees Enrolled. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. Delta Dental PPO plus Premier Benefits for Prince William County Group Number: 6292 Effective Date: July 1, 2018 Ask your dentist to file a pre-determination of benefits before treatment begins – it is not required but recommended for services over $250. Non-Delta Dental dentists have no fee restrictions. Delta Dental PPO plus Premier is Delta Dental’s preferred provider organization (PPO). A deductible is the amount you pay out-of-pocket each year before your plan begins to pay for covered dental treatment costs. Open your browser settings and turn on javascript to start finding a dentist. Delta Dental PPO plus Premier COORSTEK – Base Plan – Group # 11144-1111 MAXIMUM BENEFIT Calendar Year Maximum $1,000 per member, per calendar year CALENDAR YEAR DEDUCTIBLE Applies to Basic and Major Services Individual Deductible –$50.00 Combination of in and out -of network Family Deductible –$150.00 Combination of in and out -of network PPO Dentist PREMIER Dentist NON-PAR Dentist … $25, not to exceed $75 per family . When dentists join our PPO (Preferred Provider Organization) network, they agree to accept fees lower than those in our Delta Dental Premier network. If you have a fee-for-service benefit plan, your plan pays a predetermined percentage of the treatment cost and you’re responsible for paying the balance. Estimates should not be construed as financial or medical advice. Per person per calendar year. 50%. Delta Dental PPO and Delta Dental Premier® allowance, plus any required coinsurance and deductible (if applicable) as payment in full. What should you expect from your dentist? Monthly Rate: Single. 720 North Euclid Avenue, Pierre, SD 57501  |  605-224-7345. $37.97 on 2/1/21. Delta 1000 Monthly premium starts at $36.16 Enroll Now. SEE BASIC COVERAGE PLAN DETAILS Major Coverage. Deductible waived for Diagnostic and Preventive categories. If a member sees a Delta Dental Premier dentist who does not participate in our Delta Dental PPO ™ network, the member receives benefits as if he or she has Delta Dental Premier coverage in … Deductible. A deductible is the amount you pay out-of-pocket each year before your plan begins to pay for covered dental treatment costs. We pay your dentist directly and send you an Explanation Of Benefits. 100%. With this plan, members enjoy outstanding access and considerable savings by leveraging two of our national dental networks: Delta Dental PPO and Delta Dental Premier, the largest dental network in the country. © Delta Dental. Lower out-of-pocket costs than if you visited a dentist who doesn't participate in our networks. With the Delta Dental PPO plus Premier plan, you and your family members may visit any licensed provider. Either option offers savings and access to both of our great networks. Delta Dental PPO Plus Premier™ – Preventive Plan. Delta Dental PPOSM plus Premier With the Delta Dental PPO plus Premier plan, you and your family members may visit any licensed dentist. When dentists join our PPO (Preferred Provider Organization) network, they agree to accept fees lower than those in our Delta Dental Premier network. Delta Dental’s PPO network is one of the nation’s largest, with more than 112,000 dentists participating in over 278,000 locations nationwide. 10. Generally, Delta Dental PPOTM and Delta Dental Premier® plans have deductibles, but DeltaCare® USA, our prepaid, fixed copayment plan, does not.1. That’s great too! A PPO dentist will typically offer you the lowest out-of-pocket costs on services. It might take more than one service or visit to satisfy your entire annual deductible. $50. Employer Contribution. Depending on your dental plan, some services might not count toward your annual deductible, such as diagnostic and preventive services. Your ID card shows the type of Delta Dental plan you have, located under your name and effective date. Health Care Marketplace (Exchange) Customers: This feature uses javascript. This is not the insurance contract, and only the actual policy provisions will control. PP0 and Premier providers file claims directly with Delta Dental and accept Delta Dental’s reimbursement in full. Delta Dental PPO plan designs. Around 98% of dentists in South Dakota are members of our Premier network. Employees will love that they can be treated in-network by one of the 500 NJ dentists who accept only Delta Dental. Find out what an EOB is and how to read it. 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. Coinsurance. We’re working to add dentists in more towns across South Dakota to our PPO network. Sd 57501 | 605-224-7345 the largest network of dentists in South Dakota is a plan that covers a percentage your. Our Professional Relations team at 800-627-3961 or delta.prof @ deltadentalsd.com to refer us to your dentist treatment... In-Network by one of the Delta Dental companies, we offer Dental coverage in all 50,... In full you wish offers an added advantage to patients receiving treatment from a Delta.! 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