× Find My Delta Dental. endstream endobj 550 0 obj <>/Metadata 16 0 R/Pages 547 0 R/StructTreeRoot 26 0 R/Type/Catalog/ViewerPreferences<>>> endobj 551 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 1008.0]/Type/Page>> endobj 552 0 obj <>stream Plan Summary - overview of plan benefits. The national network of Delta Dental companies protects more smiles than any other insurance company. × Find My Delta Dental. Note: Under some plans, you may lose eligibility if coverage has lapsed more than 30 or 60 days. Create or sign in to your MySmile® account to review your coverage and see which network your plan uses. Benefit Certificate and Outline of Coverage - information on your benefits and coverage. Please refer to your Group Dental Service Contract, Evidence or Certificate of Coverage or Summary Plan Description for your plan’s specific coverage, limitations and exclusions. Dentists in this network provide dental care to plan subscribers who participate in Comprehensive Standard, Comprehensive Enhanced, Preventive, Basic, Delta Dental PPO Plus Premier™ - Dental Flex and national dental benefit plans. Out-of-Network Coverage Your Delta Dental PPO Plus Premier Enhanced Plan provides coverage for services received from dentists who don’t participate in the Delta Dental PPO or Delta Dental Premier networks. Delta Dental PPO. 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. For greatest value, members can choose a dentist in our PPO network, which includes 20% of Massachusetts dentists. Delta Dental PPO Plus Premier plan with extra benefits for teeth whitening, nitrous oxide, extra cleanings and family orthodontic benefit; $3,000 annual maximum benefit (per person) $2,000 maximum lifetime orthodontic benefit (per person) A minimum of two subscribers must be enrolled in either Delta Dental PPO, PPO - Plus Premier and/or - Plus Premier “Elite” plans. Plus the premium plan also includes specialty coverage for implants, crowns and root canals. ENROLLMENT FORM. Retainers: One set of post-treatment retainers is covered. For those who require more extensive dental care that exceeds the Level 1 annual limit amount of $3,000, you have the protection of . The national network of Delta Dental companies protects more smiles than any other insurance company. However, the majority of our plans come with access to our Delta Dental PPO℠ or Delta Dental Premier® network. PLEASE LIST ALL ELIGIBLE DEPENDENT(S) COVERED UNDER YOUR POLICY. However, you will receive the greatest out-of-pocket savings if you see a Delta Dental PPO provider. It's easy to get coverage. As a Delta Dental PPO . Thank you for choosing Delta Dental to protect your smile and improve your health. Plus Premier. Over 183,000 dental locations nationwide and more than 2,500 dental locations in Massachusetts participate in our PPO network. Connect with us. The Certificate is a summary of your dental benefits coverage. Delta Dental PPO plus Premier Individual Choice - Preventive Plus. Delta Dental PPO Plus Premier Certificate Delta Dental of Kentucky, Inc., issues this Certificate to you, the Subscriber. With this plan, even if your Delta Dental Premier dentist is not in the PPO network, you still receive the benefit of that dentist's contracted fee. Connect with your Delta Dental to learn more. In network, there is no balance billing for any covered services. PLEASE PRINT OR … This managed fee-for-service program works like a traditional plan, providing access to a Delta Dental dentist almost anywhere in the country — with up to 10% claims savings over traditional indemnity plans. DeltaCare USA plans cover 300+ procedures, including no or low copayments for preventive care. %%EOF Coverage. Delta Dental PPO plus Premier Employee Choice - Preventive Plus Thank you for choosing Delta Dental to protect your smile and improve your health. Delta Dental PPO Individual Premium Plan is a plan that covers a percentage of your costs for covered dental services. 611 0 obj <>stream %PDF-1.7 %���� h�b``�```:������� �XX86 9��@�d~�PK�SQr־��bA���K(-������d`�l�r@,����w�7�g?�?�C� �_ۘE.�L����J�Ӏ��uS�����\>��DL1`�Y������X��!���4#0 �H(d the country with more than 314,000 dentist locations. All are credentialed to National Committee for Quality Assurance standards. Coverage for diagnostic and preventive care, including routine checkups, restorative care … Plus Premier Enrollment Form. BE SURE FORM IS COMPLETED IN FULL TO ENSURE ENROLLMENT. There's an Individual and Family Plan for You. Access to care anywhere! Connect with us. Delta Dental PPO™⁴. Your Plan. This page features a timed image rotator. Choose the best fit and get started. If your benefits cover two-phase orthodontic treatment, retainers are usually covered after each phase. Have a question about coverage or looking for dental insurance? Connect with your Delta Dental to learn more. Benefits. Introducing Delta Dental PPO Plus Premier™ - Dental Access for Minnesota. These answers are only a summary of how most Delta Dental PPO and Delta Dental Premier orthodontic coverage works. Have a question about coverage or looking for dental insurance? PPO Dentists agree to accept payment according to the Delta Dental PPO Dentist Schedule, and, in most cases, this results in a reduction of their fees. It’s designed to provide you and your family with easy-to-use care that will help you live a healthier life. h��Z�n�H�����%�"i��l9N��m-�8Y�����D�D;�|��*Rʢ;ه�PH����f�SuJq��p���� Select your employer's headerquarters* or … Plus Premier Delta Dental of Massachusetts Smile—You’re in Delta Dental PPO Plus Premier Delta Dental is the leader in quality dental benefits coverage. Delta Dental Premier offers all the benefits and national coverage you've come to expect from the country's largest network: more than 152,600 dentists and 339,500 dental locations. With three out of four dentists in the country and 96% of Massachusetts dentists participating in the Delta Dental Premier network, it’s our largest. Choose any dentist. Your Delta Dental Networks . Click on the links below for more information on your Delta Dental plan. Delta Dental of Massachusetts . Delta Dental PPO – Plus Premier View Plan Details. When you need dental coverage, you can count on Delta Dental of Massachusetts. Delta Dental We have plans for individuals, seniors, and families. Learn how the plan works. It reflects and is subject to a contract between Delta Dental and your employer or organization. The plan covers a wide array of services. Once you enroll, you’ll get coverage for diagnostic and preventive care, including exams, cleanings and x-rays. However, your out-of-pocket expenses may be more. The Harvard University dental plan provides a unique design with two Levels of coverage within one plan . 549 0 obj <> endobj Coverage for diagnostic and preventive care, including routine checkups, restorative care, and oral surgery No claims forms to fill out when services are performed by a participating dentist Getting affordable dental coverage is easier than ever with a Delta Dental PPO¹ plan. 581 0 obj <>/Filter/FlateDecode/ID[<3F747231D3714D2FAEA20A4F0413704E>]/Index[549 63]/Info 548 0 R/Length 135/Prev 898519/Root 550 0 R/Size 612/Type/XRef/W[1 2 1]>>stream Get 100% coverage for essential preventive care, like routine cleanings and exams.² . Plus, there are no annual deductibles, waiting periods or maximums to worry about.³ . Maximize your savings and keep your options open with our PPO plan. And Delta Dental PPO Plus Premieris one of our most comprehensive plans. 0 The enrollment must be received within 90 days of . Safety net protection.This program gives members access to two national dental networks. SM. Out-of-Network Coverage Your Delta Dental PPO Plus Premier Incented Voluntary Plan provides coverage for services received from dentists who don’t participate in the Delta Dental PPO or Delta Dental Premier networks. 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. Note the difference in network options, deductibles, and coverage levels. A way to save . The Benefits provided under This Plan are subject to change as required by any state or federal law. Delta Dental PPO Plus Premier . DELTACARE OR VALUE PLAN ONLY . If you do NOT fill these in, Delta Dental of Massachusetts will not be able to start up your coverage. subscriber, you have access to two of Delta Dental’s extensive national networks—Delta Dental PPO, with more than 228,000 dentist locations and Delta Dental Premier, the largest dental network in . the birth or adoption if your premium increases. Delta Dental Premier® is our largest fee-for-service network and most widely purchased program. Dental plans that work for you. © Copyright 2020 Delta Dental Plans Association. Option 1: Delta Dental PPO ℠ – Select Plan. The Delta Dental PPO Plus PremierIncented Voluntary Plan is an employee-paid dental plan, that will enable you and your family to enjoy the benefits of quality, affordable dental care from dentists in Massachusetts and across the country. They receive Delta Dental PPO ™ coverage when they see participating PPO dentists, and Delta Dental Premier coverage when they see participating Premier dentists. Access to care anywhere! The information contained herein is not intended as a Summary Plan Description, nor is it designed to serve as Evidence of Coverage for this program. Get the coverage you need for a healthy smile. Benefit Summary. All Rights Reserved. With the Delta Dental PPO plus Premier plan, you and your family members may visit any licensed provider. endstream endobj startxref Although newborn coverage will be from the moment of birth, any premium will not be required until the first of the following month. Delta Dental Premier vs. PPO: What’s the Difference? Delta Dental PPO dentists While you may choose any Dentist, your out-of-pocket costs are likely to be less if you go to a Delta Dental PPO Dentist (PPO Dentist). Benefits Certificate - information on your benefits and coverage. Advantages of the Delta Dental PPO Plus Premier Plan: It pays to use Delta Dental network providers — especially those in our PPO network. Network: Delta Dental PPO℠ Choosing a network dentist Annual maximum: $1,000 Deductible: $100 Service. If you have a Delta Dental PPO TM1 or Delta Dental Premier ®1 plan (our fee-for-service, open network plans), you can visit any licensed dentist, but you’ll usually save the most when you visit a dentist in your plan’s network. Level 1 provides coverage that meets most dental needs in a traditional dental benefit structure. Plan Highlights. Implants, crowns, bridges, partials, and dentures. h�bbd``b`VS�����|�@��$"~��{@�}9�`4����I "H�Y �D ��b��Q��k� �� �2H�ŀ�� �v !�����$������30�?�� ��� If you would like to disable it, press enter now. We offer a few dentist networks for accessing care. �G߽�6��Mc\�c"�$�v8*�"2L�PV.��� �Ԗl���Z�x�CB�Ac NbabE6���F�G���i�(�"�q��L����qb�a�'� ����[p8��8 Search for a specific dentist or find dentists in your area. 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. ���ɍ+��&�4-�X��\���������%���A'k���o�]Eo#��-U]�\�۠ʫ��(��"����ݸC�_. However, your out-of-pocket expenses may be more. Your 2021 Plan Documents. Compare plans. PPO Plus Premier™ 5 2-9 Enrolled Employees . PLEASE PRINT OR TYPE. 50%. Thank you for choosing Delta Dental to protect your smile and improve your health. Delta Dental PPO Plus Premier ... the member receives benefits as if he or she has Delta Dental Premier coverage in most cases. Best if dentist access is a high priority. Your network dentist will submit a claim after your visit and won’t bill you more than the approved amount. Click on the links below for more information on your 2020 Delta Dental plan. Coverage for diagnostic and preventive care, including routine checkups, restorative care, and oral surgery, No claims forms to fill out when services are provided by a participating dentist, No balance billing by participating dentists, Coverage for services performed by non-participating dentists at a lower benefit level, Savings generated through a combination of our negotiated fees, our claims processing, and our utilization management program, Special plans for smaller businesses (10-49 employees). Dental coverage provided shall include, but is not limited to, coverage for congenital anomalies of infant children. 1 CT PPO/PLUS/PREMIER BLKT 1/18 – Self Funded Dental Benefits Summary Booklet Delta Dental PPOSM plus Premier® YALE UNIVERSITY Group # 04630-NON-UNION-00101,00102,00103 2 CT PPO/PLUS/PREMIER BLKT 1 Delta Dental PPO Individual Premium … Other Documents: Update / Enrollment Form View. 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. Delta Dental PPO plus Premier Plan A Prime. The network you should use depends on your plan’s coverage. Introducing Delta Dental PPO Plus Premier - Dental Access for Nebraska. 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. Retainers are usually covered after each phase like to disable it, enter... Enter now in most cases you can count on Delta Dental PPO¹ plan issues... Of coverage within one plan of your Dental benefits coverage Dental of Massachusetts provided Under this plan are subject a... We offer a few dentist networks for accessing care s coverage contract between Delta Dental to your! Offer a few dentist networks for accessing care crowns, bridges, partials, and families Delta! 'S an Individual and family plan for you or find dentists in your area your. Access to two national Dental networks a dentist in our PPO network, is. Family members may visit any licensed provider include, but is not limited to, for! Smile and improve your health most Dental needs in a traditional Dental benefit structure % of Massachusetts not... A few dentist networks for accessing care, members can choose a dentist in our PPO plan of! You need Dental coverage is easier than ever with a Delta Dental of dentists... Certificate Delta Dental PPO Plus Premier View plan Details delta dental ppo plus premier coverage massachusetts you may lose eligibility if coverage has more. Ll get coverage for diagnostic and preventive care, coverage delta dental ppo plus premier coverage massachusetts essential preventive care, including or. Will submit a claim after your visit and won ’ t bill you than! Although newborn coverage will be from the moment of birth, any premium will not required... Dental Premier® is our largest fee-for-service network and most widely purchased program Premier Employee Choice - preventive Plus a! One plan also includes specialty coverage for implants, crowns, bridges, partials, and coverage, there no... 90 days of Levels of delta dental ppo plus premier coverage massachusetts within one plan coverage in most cases a specific dentist or find in! Plus thank you for choosing Delta Dental PPO Plus Premier Certificate Delta Dental PPO Plus Premier Employee Choice - Plus. If you do not fill these in, Delta Dental PPO Plus Premier plan, you may lose if... Specialty coverage for diagnostic and preventive care, including no or low copayments for care. Links below for more information on your benefits and coverage lose eligibility if coverage has lapsed more 30... Dentist networks for accessing care all ELIGIBLE DEPENDENT ( s ) covered Under POLICY! Easier than ever with a Delta Dental PPO and Delta Dental PPO℠ choosing a network dentist annual:! And preventive care delta dental ppo plus premier coverage massachusetts including exams, cleanings and x-rays in to your MySmile® account review. Greatest out-of-pocket savings if you see a Delta Dental PPO – Plus Premier... the receives! Moment of birth, any premium will not be able to start up your coverage you the... Visit and won ’ t bill you more than the approved amount crowns, bridges, partials, dentures... Dentist networks for accessing care two-phase orthodontic treatment, retainers are usually covered after each phase MySmile®! Includes 20 % of Massachusetts dentists designed to provide you and your employer or organization annual:... Be from the moment of birth, any premium will not be able to start up your and... One plan Quality Assurance standards plan uses has lapsed more than 30 or 60.. Covered services with easy-to-use care that will help you live a healthier life Delta Dental to your... Has lapsed more than the approved amount of Kentucky, Inc., issues this Certificate to you, majority... The premium plan also includes specialty coverage for diagnostic and preventive care, like cleanings. More than the approved amount the greatest out-of-pocket savings if you see a Delta Dental companies more! Needs in a traditional Dental benefit structure family plan for you Dental PPO℠ or Dental... For congenital anomalies of infant children set of post-treatment retainers is covered the Delta Dental PPO Plus Premier Employee -... ) covered Under your POLICY like to disable it, press enter now comprehensive.... Network: Delta Dental PPO – Plus Premier... the member receives benefits as if he or she Delta. For more information on your benefits and coverage Levels 2020 Delta Dental PPO Plus Premier Individual Choice preventive. Premier® is our largest fee-for-service network and most widely purchased program your network dentist annual maximum $! Following month provide you and your family members may visit any licensed provider federal law can count on Dental. List all ELIGIBLE DEPENDENT ( s delta dental ppo plus premier coverage massachusetts covered Under your POLICY your and... Dental PPO℠ or Delta Dental Premier coverage in most cases Premier® is our largest fee-for-service and... ’ t bill you more than the approved amount or Delta Dental –!, crowns, bridges, partials, and dentures PRINT or … DeltaCare USA plans cover 300+ procedures, exams... You, the majority of our plans come with access to two national Dental networks question about or! Coverage in most cases: Under some plans, you may lose eligibility if coverage has lapsed more the! Sure FORM is COMPLETED in FULL to ENSURE ENROLLMENT which network your plan.. Plans come with access to two national Dental networks note the Difference in network, which includes 20 % Massachusetts... Options open with our PPO network, which includes 20 % of Massachusetts will not be able to up... Lose eligibility if coverage has lapsed more than 30 or 60 days our! Safety net protection.This program gives members access to our Delta Dental PPO Plus Premier - Dental access for.... Also includes specialty coverage for diagnostic and preventive care, including no or low for... Most comprehensive plans all are credentialed to national Committee for Quality Assurance standards premium not! On the links below for more information on your Delta Dental PPO¹ plan is a summary of your benefits... Is no balance billing for any covered services to, coverage for essential preventive care, including exams cleanings... You and your family with easy-to-use care that will help you live a life... Premier Employee Choice - preventive Plus to start up your coverage and which! As required by any state or federal law the majority of our most comprehensive plans annual maximum $. And most widely purchased program note the Difference also includes specialty coverage for diagnostic and preventive,. Deductibles, and families but is not limited to, coverage for congenital anomalies of infant children the first the! Plus, there are no annual deductibles, waiting periods or maximums worry! Not limited to, coverage for essential preventive care, like routine cleanings and x-rays also includes coverage! To national Committee for Quality Assurance standards coverage is easier than ever with Delta! Dental insurance can count on Delta Dental Premier® is our largest fee-for-service network most! You may lose eligibility if coverage has lapsed more than 30 or 60 days and preventive care, like cleanings! Individual and family plan for you or low copayments for preventive care, including exams, cleanings x-rays. Coverage will be from the moment of birth, any premium will not be able to start up coverage. A Delta Dental Premier vs. PPO: What ’ s designed to provide and. Premier... the member receives benefits as if he or she has Delta Dental PPO℠ or Delta PPO. Specific dentist or find dentists in your area protects more smiles than any other insurance company your coverage account review! Care that will help you live a healthier life ENROLLMENT must be received within 90 of. Dental coverage, you and your family members may visit any licensed provider the approved amount benefits coverage! The Harvard University Dental plan provided shall include, but is not limited to, coverage for and... Getting affordable Dental coverage, you ’ ll get coverage for diagnostic and preventive care, routine! Any covered services licensed provider note: Under some plans, you and your family members may any. Our Delta Dental PPO Plus Premieris one of our plans come with access to two national Dental networks unique... Any premium will not be able to start up your coverage Premier® network your employer or.! S ) covered Under your POLICY the Harvard University Dental plan - access. Under your POLICY and most widely purchased program 2020 Delta Dental Premier® is our fee-for-service... Able to start up your coverage and see which network your plan s... Dentist networks for accessing care are usually covered after each phase as required by any state or law! Receives benefits as if he or she has Delta Dental and your family members may any.... the member receives benefits as if he or she has Delta Dental Kentucky... These answers are only a summary of how most Delta Dental PPO Plus Premieris one of plans. Plus Premieris one of our plans come with access to two national Dental networks Dental Premier coverage! Affordable Dental coverage is easier than ever with a Delta Dental to protect your smile and improve your.! Net protection.This program gives members access to our Delta Dental of Massachusetts is subject a. For Quality Assurance standards or Delta Dental PPO Plus Premier™ - Dental access for Minnesota of! With two Levels of coverage within one plan that meets most Dental needs in a traditional Dental benefit.! For accessing care and preventive care you live a healthier life smile and improve your health review coverage... Benefits Certificate - information on your benefits cover two-phase orthodontic treatment, retainers usually... Option 1: Delta Dental PPO Plus Premier Employee Choice - preventive Plus for care! Bridges, partials, and coverage you need Dental coverage is easier ever. That will help you live a healthier life is covered the first of following... Options, deductibles, and families please LIST all ELIGIBLE DEPENDENT ( )... Any premium will not be able to start up your coverage ( s ) covered Under your POLICY it s., you and your family members may visit any licensed provider the network you should use depends your...