About Your Dental Plan
All of our plans are designed to provide
you and your family with access to easy-to-use care that will help you
maintain your teeth for life. After all, the better we help
you take care of your teeth, the better your family will look
and feel. Click on the dental plan you are enrolled in.
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Member Update on Coordination of Benefits
Delta Dental of Massachusetts has provided the following notice to clients that,
effective on October 31, 2011, it is changing how it administers the Coordination of Benefits (COB).
As a result of this change, the amount paid by Delta Dental as the secondary plan may be less than it pays
under the current COB policy and in no circumstance will it be more. If the amount paid by Delta Dental is less,
this will reduce the amount charged against a member’s calendar year maximum dollar payment.
NOTICE OF CHANGE TO COORDINATION OF BENEFITS
The following provision replaces the Coordination of Benefits provision in
the Subscriber’s Certificate:
Coordination of Benefits (COB) applies if you or any of your dependents have
another plan that provides coverage for services that are benefits under your contract. Delta Dental will administer
the COB according to the applicable state Coordination of Benefits law and this Subscriber’s Certificate.
The plan that provides benefits first under the COB rules is known as the primary
plan. The primary plan is responsible for providing benefits in accordance with its terms and conditions of
coverage without regard to coverage under any other plan. The plan that provides benefits next is the
secondary plan. It provides benefits toward any remaining balance for covered services in accordance with its
terms and conditions of coverage, including its COB provision.
Delta Dental, as the secondary plan, will provide benefits toward any remaining
patient balance for covered services in accordance with your contract, provided that the amount paid by
Delta Dental
as the secondary plan, when added to the amount paid by the primary plan, will not exceed the lesser of the
provider’s submitted charge or the amount allowed under your Delta Dental contract.
IMPORTANT: No statement in this section should be interpreted to mean that we
will provide any more benefits than those described in the Benefits Section of your
contract. If you have any
questions about COB or your contract, please contact our Customer Service Department. The telephone numbers are
listed at the end of the Subscriber’s Certificate.
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Delta Dental Premier (Formerly known as DeltaPremier)
- Operates much like a traditional fee-for-service plan
that allows you to pick your own dentist.
- Ability to choose from close to 6,600 access points in Massachusetts—that's
96% of the state's dentists.
- Covers diagnostic and preventive care, including routine
checkups, and restorative care, including oral surgery.
- No claims forms to fill out when you receive services
from a participating dentist.
- No balance billing by participating dentists.
- Covers services performed by non-participating dentists
at a lower benefit level.
- Your Member Guide
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Delta Dental PPO (Formerly known as DeltaPreferred Option)
- A Preferred Provider Organization (PPO) that reduces your
out-of-pocket costs while allowing you to choose from more than 2,000 dentist locations in Massachusetts.
- All participating dentists are credentialed to National
Committee for Quality Assurance (NCQA) standards.
- Covers diagnostic and preventive care, including routine
checkups, and restorative care, including oral surgery.
- Participating dentists are reimbursed through a combination
of Delta Dental payments and patient co-payments.
- No claims forms to fill out when you receive services
from a participating dentist.
- No balance billing by participating dentists.
- Covers services performed by non-participating dentists
at a lower benefit level.
- Your Member Guide
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Delta Dental PPO Plus Premier (Formerly known as Delta Preferred Option Plus)
- A Preferred Provider Organization (PPO) that reduces your
out-of-pocket costs while allowing you to choose from more than 2,000 dentist locations in Massachusetts.
- Combines two national networks, Delta Dental PPO and Delta Dental Premier, giving you access to dentists who participate in both.
- All participating dentists are credentialed to National
Committee for Quality Assurance (NCQA) standards.
- Covers diagnostic and preventive care, including routine
checkups, and restorative care, including oral surgery.
- Participating dentists are reimbursed through a combination
of Delta Dental payments and patient co-payments.
- No claims forms to fill out when you receive services
from a participating dentist.
- No balance billing by participating dentists.
- Covers services performed by non-participating dentists
at a lower benefit level.
- Your Member Guide
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DeltaCare
- A comprehensive managed care plan that focuses on preventing
dental disease.
- Ability to choose from a network of more than 750 access points in Massachusetts.
- All participating dentists are credentialed to National
Committee for Quality Assurance (NCQA) standards.
- Covers orthodontics (braces) for members and their families,
regardless of age.
- Covers diagnostic and preventive care, including routine
checkups, and restorative care, including oral surgery.
- No claims forms to fill out when you receive services
from a participating dentist.
- No balance billing by participating dentists.
- Covers services performed by non-participating dentists
at a lower benefit level.
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Delta Dental PPO
Value Plan (Formerly known as Preferred One)
The Delta Dental PPO Value Plan (formerly known as Preferred One) covers you 100% for diagnostic and preventive services only (no deductible) when you
receive care from a Delta Dental PPO dentist. Most basic and major restorative dental services are offered at significant
discounts when you receive care from a Delta Dental PPO dentist.
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Voluntary Plans
An employee paid dental plan
available through your employer. Our Voluntary Plans provide
access to an extensive network of dentists and offer significant
savings when compared to traditional indemnity plans.
- Comprehensive plans that cover most dental services including
100% coverage for cleanings, check-ups and x-rays.
- Receive benefits for restorative services including fillings,
crowns, and dentures.
- Never pay a network deductible.
- Receive from $750 up to $1,000 per person in dental coverage each
year depending on your plan.
- No claims forms to fill out when you receive services
from a participating dentist.
- No balance billing by participating dentists. Your participating
dentist will accept the combination of your co-payment (if
applicable) and Delta Dental's reimbursement as payment
in full for all covered services.
For more details, please click here to view our Voluntary Plans PDF.
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Delta Dental Premier
for Individuals
New! Now you can purchase a Delta Dental plan for yourself and your family. Two affordable dental plan options are available, both giving you access to 96% of Massachusetts’ dentists and thousands more across the country through the Delta Dental Premier Network.
For more details, please click here to view our option plans.
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