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InsuranceCompany.com  an affiliate of Del Amo Insurance Services, Inc., through its' brokerage services, can arrange dental benefits with the Delta Dental Plan Association, is a specialist in dental insurance, dental discount plans, vision and prescription coverage programs throughout the United States. We offer several national dental insurance, vision and prescription programs with membership in its dental insurance and/or discount plans depending upon the state you live in.

InsuranceCompany.com is a marketing affiliate and a wholly owned subsidiary of Del Amo Insurance Services, Inc., a California corporation, license #0B93601 DBA: InsComp Insurance Services, an agent of Delta Dental PMI in California, Florida, Texas, Utah; and MWG in Alabama, Delaware, Washington DC, Florida, Georgia, Louisiana, Maryland, Mississippi, Montana, Nevada, New York, Pennsylvania, Texas, Utah, West Virginia. All Delta Dental products are registered trademarks or service marks of Delta Dental Plans. Click here for Delta Dental© Copyright Information.

For assistance with your current Delta Dental Plan policy please refer to DeltaDental.com.

DeltaCare programs provide rigorous controls to assure quality care. Network dentist undergo on-site quality audits. Auditors examine office hours, number of staff members, convenience of location, sterilization techniques, recordkeeping, opportunities available to staff, type of equipment, continuing education, range of services provided and the dentist's own quality assurance system. Contracted dentists must have been in practice for at least five years and must be able to provide 24-hour emergency service. Once accepted into the network, the dentist's office is visited regularly by a DeltaCare representative.

The DeltaCare panel includes oral surgeons, endodontists, pedodontists, periodontists and orthodontists. When a DeltaCare primary care dentist refers a patient to a specialist, the DeltaCare program reimburses the specialist directly for prior authorized treatment. Unlike many managed care dental programs, DeltaCare doesn't require the primary care dentist to pay for specialty care, a practice which encourages appropriate referral. (The patient pays the same copayment for specialty care services whether performed by the primary care dentist or by a referred specialist.)

DeltaCare offers a broad range of covered benefits:

All services are covered in full or with patient co-payments as shown in the schedule of benefits and co-payments.

  • Diagnostic and preventive services, including examinations, consultations and x-rays. Also included are prophylaxis (cleaning), topical application of preventive solutions and sealants (age limitations may apply) and space maintainers.
  • Emergency services, to relieve pain and infection.
  • Restorative services, including amalgam, porcelain and plastic restorations (fillings) for treatment of carious lesions (visible destruction of tooth surface resulting from the process of decay). Crowns and jackets are also covered when teeth cannot be restored with the materials mentioned above.
  • Oral surgery, including extractions and certain other surgical procedures.
  • Endodontics, including pulpal therapy and root canal filling.
  • Periodontics, treatment of the tissue supporting the teeth.
  • Fixed bridges, covered subject to administrative policies.
  • Removable prosthetics, including full or partial dentures.
  • Orthodontic care, for adults and/or dependent children, subject to the availability of network orthodontists.

DeltaCare dentists receive a predetermined amount each month for each patient enrolled with their office. Because these dentists have already contracted to provide services to DeltaCare patients, there are no claim forms.

Limitations on all Benefits - Optional Services:

Services that are more expensive than the form of treatment customarily provided under accepted dental practice standards are called "Optional Services." Optional Services also include the use of specialized techniques instead of standard procedures. For example: a crown where a filling would restore the tooth, a precision denture where a standard denture could be used, or an inlay instead of a restoration. If you receive Optional Services, your Benefits will be based on the lower cost of the customary service or standard practice instead of the higher cost of the Optional Service. You will be responsible for the difference between the higher cost of the Optional Service and the lower cost of the customary service or standard practice.

Exclusions
Delta Dental does not pay Benefits for:

a) Services for injuries or conditions which are compensable under workers' compensation or employers' liability laws; services which are provided to the Enrollee by any federal or state government agency or are provided without cost to the Enrollee by any municipality, county or other political subdivision except as such exclusion may be prohibited by law.

b) Services with respect to congenital (hereditary) or developmental (following birth) malformations or cosmetic surgery or dentistry for purely cosmetic reasons, including but not limited to cleft palate, maxillary and mandibular (upper and lower jaw) malformations, enamel hypoplasia (lack of development), fluorosis (a type of discoloration) of the teeth, and andontia (congenitally missing teeth), except those services provided to newborn children for congenital defect or birth abnormalities or services that may be provided under Orthodontic Benefits.

c) Services for restoring tooth structure lost from wear, erosion, or abrasion, for rebuilding or maintaining chewing surfaces due to teeth out of alignment or occlusion, or for stabilizing the teeth. Such services include, but are not limited to: equilibration, periodontal splinting, occlusal adjustment.

d) Any Single Procedure started prior to the date the person became covered for such services under this program.

e) Prescribed drugs, medication or analgesia.

f) Experimental procedures.

g) Charges by any hospital or other surgical or treatment facility and any additional fees charged by the Dentist for treatment in any such facility.

h) Charges for anesthesia, other than by a licensed Dentist for administering general anesthesia in connection with covered oral surgery services.

i) Extra oral grafts (grafting of tissues from outside the mouth to oral tissues).

j) Services with respect to any disturbance of the temporomandibular joint (jaw joint).

k) Services performed by any person other than a Dentist or auxiliary personnel legally authorized to perform services under the direct supervision of a Dentist.

l) Replacement of teeth extracted prior to the member's effective date.
The preceding information is a brief description of coverage. Contact Benefits Association for complete details.



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