Minimize your out-of pocket expense for dental care by asking your dentist for a pre-treatment estimate from Delta Dental before you agree to receive any prescribed, major treatment. This lets you know up front what the plan will pay, and the difference you will be responsible for. Your dentist may be able to present alternative treatment options that will lower your share of the bill, while still meeting your basic dental care needs. (This service is not available to DeltaCare® USA enrollees.)
What is a pre-treatment estimate?
A pre-treatment estimate is a free service that Delta Dental provides to its enrollees. It can help you and your dentist make more informed decisions about your dental care.
A pre-treatment estimate is particularly useful for more costly procedures such as crowns, wisdom tooth extractions, bridges, dentures or periodontal surgery. When your dentist submits a pre-treatment estimate to Delta Dental, Delta Dental will send an estimate of your share of the cost and how much Delta Dental will pay.
Why should I consider a pre-treatment estimate?
A pre-treatment estimate is a good idea if you are having extensive work done and want to know what your share of the cost will be. Also, you can find out:
- If the procedures are covered
- If you will exceed your maximum
- How best to plan your payment portion
How does it work?
Your dentist sends Delta Dental a proposed treatment plan, along with relevant x-rays. Delta Dental then checks to be sure that the services are covered. Some dental work may be limited or excluded by your plan, and a pre-treatment estimate will help you understand which services are covered before you proceed with treatment.
Delta Dental also calculates how any coinsurance and dollar maximum limits might affect your share of the cost. You and your dentist then receive an estimate of the amount Delta Dental will pay for approved services and the amount of your payment portion.
A pre-treatment estimate is not a guarantee of payment. When the services are complete and a claim is received for payment, Delta Dental will calculate its payment based on your current eligibility, amount remaining in your annual maximum and any deductible requirements.
How long does it take?
Pre-treatment estimates usually take about three weeks. To provide faster turnaround, a pre-treatment estimate does not take into account any deductibles, so please remember to figure in your deductible, if necessary.
Unless the need is urgent, it's worthwhile to find out how much of your treatment is covered, allowing you to plan in advance for your portion of the dentist’s bill.