Treatment Options and Costs
When planning your treatment, it’s important to know the costs, available treatment options and your plan’s benefits. To make the best decision about your dental treatment, review your plan information and talk to your dentist.
Talk to your dentist
Feel free to ask your dentist about the cost of treatment before having work done. If you are choosing between different treatment options, price may be a relevant factor in making your decision.
A simple way to determine your expected cost is to ask your dentist to request a free pre-treatment estimate from Delta Dental. (This service is available under all plan types except DeltaCare USA.) A pre-treatment estimate is particularly useful for more costly procedures such as crowns, bridges, dentures, periodontal surgery or wisdom tooth removal.
After Delta Dental reviews your x-rays, diagnosis, proposed treatment plan and coverage, you and your dentist will receive a statement showing the estimated amounts you and your dental plan will each be responsible for. Some dental work may not be covered or may be subject to limitations udner your plan. A pre-treatment estimate can help you avoid any surprises before undergoing major treatment.
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, your plan benefits, the amount remaining in your annual maximum and any deductible requirements.
Review your coverage information
Delta Dental’s payment for treatment will vary, depending on your plan and the dentist you visit.
Some Delta Dental plans, like Delta Dental PPOTM and Delta Dental Premier®, may offer a higher level of coverage if you select an in-network dentist. With DeltaCare® USA, you and your family members must select and visit a DeltaCare USA primary care dentist in order to receive benefits.
Under most Delta Dental PPO and Premier plans, the plan covers a certain percentage of the cost, but the actual amount you owe depends on the dentist’s fees. For example, your costs may be lower when you visit an in-network dentist. Some plans cover a certain dollar amount for each procedure using a table of allowance. You pay the difference between the allowance and your dentist’s accepted fee. Prepaid plans, like DeltaCare USA, have set copayments for each service, so you can calculate in advance how much you’ll owe the dentist.
The best way to understand your plan benefits is to check your Evidence of Coverage booklet or review your benefits online. In order to log in to your online account, you must first complete a short, one-time registration process. You’ll be able to check your eligibility and benefits, including maximums, deductibles, and coinsurance percentages or copayment amounts for different types of dental services. Once logged in, you can also search for a dentist and see only the dentists in your plan’s network.
Get a cost estimate
To get an estimate of how much a procedure will cost, log in to your Online Services account and click on “Cost Estimator” by your name. You’ll receive an estimate for that procedure based on dentist fees in your area. This service, which features the most common dental procedures, is only available under PPO plans.