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Dental benefits
help you take care of your family's oral health. Here
are some strategies to help you manage costs while
getting the most out of your dental benefits plan.
Know what your
plan covers. Delta Dental offers many different
types of dental programs. The specifics of each plan
depend on what type of coverage your employer selected.
You can view details about your plan, and how it applies
to you, by using our online Benefits Connection.
Benefits Connection provides an in-depth explanation of
what your program covers, from routine diagnostics (such
as exams, cleanings and x-rays) to more extensive
procedures (such as oral surgery and root canals). To
access Benefits Connection, go to www.deltadentalnj.com,
click "Members," and "Logon" in the Benefits Connection
Logon box. If you've never used Benefits Connection,
click "Register Now" so you can start accessing its
features.
Learn some
benefits terminology. When you read about your
dental coverage in Benefits Connection, you may
encounter some unfamiliar terms. Understanding these
terms will help you understand your financial
obligations under your group's dental plan.
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Benefits percentage means the percentage of
the procedure cost that Delta Dental covers. If your
plan's benefits percentage for exams is 100%, Delta
Dental covers all of the cost of the exam.
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Deductible is the amount you must pay the
dentist before Delta Dental begins paying for
treatment. If your plan includes a $50 annual
deductible, it means that you must pay for the first
$50 of dental treatment each year. Delta Dental's
coverage begins after you have paid the deductible.
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Co-payments are a fixed fee that you pay for
specific services covered by your plan. Some plans
require subscribers to make a set co-payment each time
they visit the dentist.
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Frequency limitations describe how often each
calendar year each subscriber may receive a particular
service. If your plan covers two cleanings per year at
100%, with no deductibles or co-payments, you will
have no out-of-pocket expenses for those two
cleanings. Any additional cleanings would not be
covered.
Request a
pre-treatment estimate. For some more extensive
dental treatment, you may want your dentist to submit a
request for a pre-treatment estimate (PTE) to Delta
Dental. Delta Dental will process the PTE and send your
dentist an explanation of benefits, which shows what
would be covered and how much you would have to pay. If
your dentist also uses Benefits Connection, he or she
can submit your PTE immediately online, while you are
still in the office. Depending on the procedure, your
dentist may learn your coverage for the treatment before
you leave his or her office. Please keep in mind that
although a PTE may state that Delta Dental will pay a
certain amount for a procedure, it is not a guarantee of
payment, as circumstances (such as additional claims
processed before the PTE work is done) may change. |
