Delta Dental
Dental for Everyone Platinum Premier
- Benefits up to $1500 per calendar year (including ortho benefits)
- Benefits increase after the first and second year
- Ortho benefits for dependent children included at no extra charge
- Keep your dental plan regardless of age
- $100 lifetime deductible for ortho
- Freedom to choose any dentist
- 6 month waiting period for basic
- 12 month waiting period for major and ortho
| Common procedures: | |
|---|---|
| Cleaning: | 80-100% |
| White Filling: | 60-80% |
| Crown: | 0-50% |
| Root Canals: | 0-50% |
| Simple Extractions: | 0-50% |
| Plan Maximum: | $1500 per calendar year, per insured person For Orthodontia: $350 calendar year maximum and $1000 lifetime maximum |
| Waiting Periods: | Preventive-None, Basic-6 months, Major-12 months |
| Deductible: | Combined Deductible for Diagnostic, Basic and Major Procedures: $50 per person per calendar year Orthodontia Deductible: $100 lifetime |
| Details: |
|---|
| Fee Schedule: N/A | Dentist Search | Exams: |
| Routine periodic examinations – twice in a calendar year 1st Year – 80% after deductible 2nd Year – 90% after deductible 3rd Year and after – 100% after deductible Preventive – No waiting period | Cleanings: |
| Teeth Cleanings – twice in a calendar year 1st Year – 80% after deductible 2nd Year – 90% after deductible 3rd Year and after – 100% after deductible Preventive – No waiting period | X-Rays: |
| Radiography: Bitewing and full mouth x-rays 1st Year – 80% after deductible 2nd Year – 90% after deductible 3rd Year and after – 100% after deductible Preventive – No waiting period | Fillings: |
| Restorative Amalgam Fillings. Resin-based composite (white fillings) anterior only 1st Year – 60% after deductible (6 months waiting period) 2nd Year – 70% after deductible 3rd Year and after – 80% after deductible Basic – 6 months waiting period | Extractions: |
| Extractions and other oral surgery, including pre- and post-operative care 1st Year – 0% (12 months waiting period) 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – 12 months waiting period | Crowns: |
| 1st Year – 0% (12 months waiting period) 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – 12 months waiting period | Root Canals: |
| Endodontics: Pulpal therapy and root canals 1st Year – 0% (12 months waiting period) 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – 12 months waiting period | Dentures: |
| 1st Year – 0% (12 months waiting period) 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – 12 months waiting period | Deep Cleanings: |
| Treatment of diseases of the gums 1st Year – 0% (12 months waiting period) 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – 12 months waiting period | Implants: |
| Not Covered Service | Braces/Orthodontia: |
| For eligible dependent children only 1st Year – 0% (12 months waiting period) 2nd Year – 40% after $100 Lifetime Orthodontia Deductible per dependent, up to $350 calendar year maximum and $1000 lifetime maximum 3rd Year and after – 50% after $100 Lifetime Orthodontia Deductible per dependent, up to $350 calendar year maximum and $1000 lifetime maximum Deductible and Maximums are per eligible dependent child Major – 12 months waiting period | Teeth Whitening: |
| Not Covered Service | Additional Network Information: |
Delta offers Delta Dental Premier Plan (Indemnity Plan) or a Delta Dental PPO plan. The Premier Plan rates are based on Delta Dental’s Premier network. Both Premier and Non-Delta Dental dentists are reimbursed on Usual, Reasonable and Customary (UCR) charges. The Premier dentist will file the claim with Delta Dental and will not balance bill. PPO coverage rates are based on Delta Dental’s PPO network. Benefits for all dentists are based on Delta Dental’s reduced PPO fee schedule. PPO dentists will file the claim with Delta Dental. There is no balance billing for PPO dentists. Exclusions and LimitationsPrivacy Policy Plan Brochure |
FAQ:
Can I change my dentist once I am in the plan?
Yes, you may change your dentist at any time.
What is a pre-existing condition versus work-in-progress? Is it covered?
A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program. The plan does not include an exclusion for pre-existing conditions.
Work in progress is any oral health procedure that is started and not completed prior to your enrollment in a dental program. The plan does not cover any expenses prior to the date you are covered under the Policy.
What provider options do I have?
This is an Indemnity plan, which allows you complete freedom of dentist choice. However, Delta Dental Premier participating dentists have agreed to file the claim for you and to accept the amount approved by Delta.
The Premier Plan rates are based on Delta Dental’s Premier network. Both Premier and Non-Delta Dental dentists are reimbursed on Usual, Reasonable and Customary (UCR) charges. The Premier dentist will file the claim with Delta Dental and will not balance bill. The Non-Delta Dental dentist will not file the claim and will balance bill.
When can I start using my Plan?
You can start using your plan once it goes into effect - usually the 1st of the month following your enrollment (as long as the enrollment and payment is received within the enrollment deadline). Incomplete enrollment forms or failure to submit the required initial premium amount may cause an initial delay in issuance of insurance. Do not cancel any other insurance or assume you are insured under the Plan until you receive your certificate of insurance.
When will I receive my new member kit and what will it include?
Once you have completed and submitted your application, you will receive an “Enrollment Confirmation” email from noreply@morganwhite.com. The email will contain a link so you can download your Coverage Document and ID card. To help ensure successful delivery of the email, please add “@morganwhite.com” to your safe senders list.
Who can enroll in this plan?
Individuals who are 18 years of age, and their eligible dependents (unmarried children from birth to age 26). Individuals 65 years of age and over are eligible to enroll, and will be charged the same rate as those enrollees under 65.
As long as you meet the plan’s general eligibility requirements and pay the applicable premium, your acceptance is automatic.
P. O. Box 1809
Alpharetta, Georgia 30023-1809
Disclaimers and Disclosures:
Dental for Everyone Plans are underwritten by Delta Dental Insurance Company. Coverage under the plans is available only to Benefits Association Inc. (BAI) members. If you are not a member of BAI you must join to be eligible for Dental for Everyone Plans. Estimated premium includes the $1.00 per month membership dues for BAI and a monthly billing fee. Coverage under the plans is only available to BAI members in AL, CA, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, TX, UT and WV.
This is a general group summary of the features of the Delta Dental Insurance Company plan issued to Benefits Association, Inc. When you purchase the plan you will receive a Certificate of Coverage that details your rights and obligations, as well as those of the insurance company.
This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.
Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.
This site was designed to provide you with a general description of the plans you requested. Keep in mind that it does not include all the benefits and limitations outlined in the policies -- it is the insurance contract, not the general descriptions on this website, which forms the contract between you and the insurance company.
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