Your assigned Contract Dentist maintains a 24-hour Emergency Service system seven days a week. The Contract Dentist will provide Emergency Services for covered dental procedures whenever possible. If you require Emergency Services and are 35 miles or more from your Contract Dentist's facility, or you are unable to reach your Contract Dentist, you may seek treatment from a Dentist other than your assigned Contract Dentist. Benefits for emergency treatment provided by an out-of-network Dentist are subject to a $100.00 maximum, per Enrollee, per emergency. You will be responsible for the Copayment(s) as well as any charges over the $100.00 benefit maximum.

You can receive your covered out-of-network emergency dental care when you are outside of the United States through a partnership between ALPHA and International SOS Assistance, Inc. (I-SOS). I-SOS provides referrals to 3,200 dentist or dental clinics in nearly 200 countries worldwide. English-speaking operators are available around the clock to help you find a dentist. For more information, check our website at www.deltadentalins.com/deltacareusa or call 800-523-6586 from the U.S. Once you leave the U.S., you can call I-SOS at 215-942-8226 - collect.

When you see an I-SOS dentist, you must pay for your treatment at the time of service and get a detailed receipt from the dentist. In addition to providing the dentist’s name and address (including country), this receipt should describe the services performed by the dentist and indicate the tooth or teeth that were treated. It should also indicate whether the dentist’s charges were billed in U.S. dollars or another currency.

Once we receive your claim, we will reimburse you subject to the terms and conditions of your DeltaCare USA coverage. Reimbursement is based on the out-of-network emergency benefit provided through your plan, noted above. As with any dental plan, this reimbursement may not cover the entire cost of the treatment rendered.