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Your assigned Contract Dentist maintains a 24-hour Emergency Services system seven days a week. If Emergency Services are needed, you should contact your Contract Dentist whenever possible. Benefits for Emergency Services by any other Dentist are limited to necessary care to stabilize your condition and/or provide palliative relief when you:
1) have made a Reasonable attempt to contact the Contract Dentist and the Contract Dentist is unavailable or you cannot be seen within 24 hours of making contact;
or
2) have made a Reasonable attempt to contact Delta Dental prior to receiving Emergency Services, or it is Reasonable for you to access Emergency Services without prior contact with Delta Dental;
or
3) reasonably believe that your condition makes it dentally/medically inappropriate to travel to the Contract Dentist to receive Emergency Services. Benefits for Emergency Services not provided by the Contract Dentist are limited to a maximum of $100.00 per emergency, per enrollee less the applicable Copayment. If the maximum is exceeded, or the above conditions are not met, you are responsible for any charges for services by a provider other than your Contract Dentist.
Benefits for Emergency Services not provided by the Contract Dentist are limited to
a maximum of $100.00 per emergency, per enrollee less the applicable Copayment.
If the maximum is exceeded, or the above conditions are not met, you are responsible
for any charges for services by a provider other than your Contract Dentist.
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