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DeltaCare® Plan #3100

 

You have chosen the DeltaCare® Plan

GROUP #03100

DELTA CARE PLAN
 
• Requires primary care dentist (PCD) from the DeltaCare® network
• DeltaCare® PCD must refer you for any specialized care
• No deductibles
• Fixed dollar copays
• No coverage for out-of-network care
• Responsive, local customer service
 

COPAY:  On the DeltaCare plan, you pay a fixed dollar amount for each treatment you receive.

 
 

Here's how to get the most from your coverage

STEP 1
Activate your MySmile® account
Easy, secure access to all your custom dental benefit information on your phone or desktop!
 
• Print your ID card
• Endorse your favorite DeltaCare dentist
• Review your coverage
• Accounts are available for subscribers and their dependents ages 18+
 
STEP 2
Find a primary care dentist (PCD) from the DeltaCare® network
Find a DeltaCare® PCD near you:
 
• Find a Dentist Tool
• Select 'DeltaCare' to filter your search results
• Contact the dental office to confirm they're accepting new patients
If you want to change your PCD, you can do so at any time.
• Find A Dentist from the DeltaCare® network
• Call us at (800) 650-1583 and we'll make the change
• Make your request by the 20th of the month to start seeing your new PCD on the 1st of the following month
 
STEP 3
Review your DeltaCare® costs
ANNUAL COSTS
 
Deductible   $0
Plan maximum   No annual maximum
 
YOU PAY PER SERVICE
 
Cleaning and exam every 6 months   $0
Fluoride treatment   $0
Complete x-rays every 3 years   $0
Fillings   $10 to $50
Crowns   $100 to $175
Root canals (endodontics)   $100 to $150
Treatment of gum disease (periodontics)   $15 to %100
Tooth extractions   $10 to $50
Orthodontia   up to $1,500 per case
Implants   $2800 per tooth
Dentures   $140 per arch
Nonsurgical TMJ   30% up to $1,000 per year or $5,000 lifetime annual maximum. Patient pays any cost exceeding lifetime annual maximum.
view and download your certificate of coverage
 
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