What do Delta Dental member services include?


Quick Answer

Delta Dental member services include preventive and diagnostic services, basic services such as fillings and extractions, and major services such as prosthodontics, according to Delta Dental. The extent of services covered, the co-pay amount and deductible vary by plan.

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Full Answer

Delta Dental covers a certain portion of dental expenses, depending on the individual plan, using a three-tiered approach. Class I procedures, for preventive and diagnostic care, are usually covered between 80 and 100 percent of the maximum allowable per plan. Class II procedures are usually covered at 70 to 100 percent and include basic procedures such as fillings and extractions. Class III procedures, which are generally major procedures, are covered at around 50 percent and require a waiting period for services.

Limits and exclusions vary by plan and can be found in the plan's guidelines, which are available by request. In addition, the dentist may limit or deny benefits for procedures depending on individual circumstances, in accordance with Delta Dental's guidelines, for such things as crowns, inlays, cast restorations and prosthodontics, and even for some basic benefits, so individual coverage may vary. Patients may request that the dentist submit a pre-treatment cost estimate so they can be aware ahead of time what their out-of-pocket expenses will be, suggests Delta Dental.

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