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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.
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.
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