To table of contents 3 d2929 prefabricated porcelainceramic crown. The program has been established and is administered in accordance with the provisions of a group dental service contract. Welcome to deltacare usa quality, convenience, predictable costs deltacare usa is a dental program that provides you and your family with quality dental benefits at an affordable cost. However, deltacare usa plans have no exclusion for preexisting dental conditions or missing teeth. Most exams and procedures are paid on a percentage basis up to a plan maximum. Your employer has chosen to participate in the exchange and you have selected delta dental of california delta dental to meet your dental insurance needs. Delta dental ppo delta dental premier delta dental ppo plus premier deltacare usa. This booklet is a combined evidence of coverage and disclosure form eoc for your deltacare usa dental hmo program program provided by delta dental of california delta dental. Any general dentist oral surgeon endodontist orthodontist pediatric dentist periodontist prosthodontist oral pathologist public health full time faculty oral maxillofacial radiologist.
The plan is unique in its emphasis on preventive services, which are fully covered. Preventive care, like routine cleanings and exams, is covered at little or no cost. There are three types of dental plans available, prepaid, indemnity, and ppo. The national delta dental hmotype program is the most costefficient program for employers with employees throughout the country. Deltacare usa dental health care program this booklet is an evidence of coverage eoc for your deltacare usa dental health care program program provided by dentegra insurance company dentegra. Does my plan cover toothcolored fillings and crowns. Call customer service for help in finding a deltacare usa dentist. Every deltacare usa enrollee is mailed a combined evidence of coverage and disclosure form eoc booklet within 30 days of enrollment as part of a welcome packet that also includes id cards. Aarp dental insurance plan administered by delta dental. With deltacare usa, employers can provide comprehensive benefits when members visit participating deltacare usa dentists. As a costco member, you can get comprehensive dental coverage from your choice of skilled primary care dentists in our networkall at an affordable price.
Deltacare usa is a closed network product that features set copayments, no annual deductibles and no maximums for covered benefits. Youll need to visit your primary care dentist to receive benefits. If the facility is not open to new membership, you will have to select another participating provider. Retention including retainers coverage varies depending on your plan, but most delta dental plans include. If you are shopping for individual dental insurance, have individual dental insurance or have general questions, enter the state you live in. Select a primary care dentist, who will then coordinate any needed referrals to a specialist. Deltacare, a managed dental benefit plan of coverage. Choose your network dentist select a skilled primary care dentist from the deltacare usa network.
Visit our website on your mobile device or desktop, and click on find a dentist on our home page. When you call to schedule your appointment, inform the office that you are a member of the deltacare usa dental plan. Deltacare usa is delta dentals dental hmo, which offers lowcost dental coverage with a focus on preventive care. Calhr currently contracts with four prepaid dental plans. Welcome to deltacare deltacare is an innovative dental plan that provides you with comprehensive care at a significantly lower cost than most other dental plans which means great value for you. Your dental plan guide delta dental for individuals and families. This booklet, which explains program eligibility and general provisions, constitutes the.
Deltacare usa frequently asked questions delta dental for. Quality convenience predictable deltacare costs usa deltacare usa. The deltacare program offers subscribers and covered. Deltacare usa a prepaid dental plan for university of california employees, retirees, and. If you require treatment from a specialist, your primary care dentist will coordinate your specialty care.
Call customer service for help in finding a deltacare dentist. Deltacare usa plan, but would like to maintain the same dentist. To find the most current listing of deltacare usa network dental offices. Currently available in az, ca, fl, md, nv, or, pa, tx and wa external link. You can also call customer service for help in finding a. Oct 06, 2017 calhr currently contracts with four prepaid dental plans. This dentist provides most of your treatment and coordinates any necessary specialist referrals. Calhr also contracts with delta dental delta for an indemnity plan and a preferred provider option plan. Deltacare usa plan features no deductibles, no clearly defined copayments no annual deductibles and no maximums low or no costs for many services such. Orthodontic treatment in progress is limited to new deltacare usa enrollees who, at the time of their original effective date, are in active treatment started under their previous employer sponsored dental plan, as long as they continue to be eligible under the deltacare usa program. Group name dental plan combined evidence of coverage and disclosure plan xgecadc19 1 introduction we are pleased to welcome you to the deltacare usa dental plan. View notes deltacare plan booklet from computer s 222 at santa monica college. When you enroll, you select a network dentist to provide all your basic dental services and to refer you to specialists when necessary.
Dentists receive a flat fee for each member assigned to their offices. Porcelain and other toothcolored materials are included in this plan. When you enroll, you can select a network dentist to provide all of your basic dental service or the plan will assign you a dentist near your home. Deltacare usa program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health.
You may schedule an appointment by calling the dental office you selected on or after your effective date of coverage. Pre and posttreatment records xrays and study models limited, interceptive and comprehensive orthodontic treatment. Orthodontic coverage delta dental for individuals and. External bleaching is a benefit under your deltacare usa plan. The national network of delta dental companies protects more smiles than any other insurance company. Visit our website and click on find a dentist on our home page.
We, us or our means delta dental of california or the administrator as appropriate. When there are more than six crowns in the same treatment plan, an enrollee may be. Deltacare usa, premier access, safeguard, and western dental. Deltacare, a managed care dental plan administered by delta dental of washington introduction delta dental of washington ddwa is a notforprofit dental service corporation. Some deltacare usa plans may cover inprogress orthodontic treatment. How to use the deltacare usa plan choice of contract dentist 3. The deltacare usa network consists of private practice dental facilities that have been screened by delta dental for quality.
Deltacare usa plans dhmo dental plans dental services that are not performed by your selected innetwork participating contracted dentist, or are not covered under provisions for emergency care below, must be preauthorized by us to be covered by your deltacare usa program. Deltacare usa provided by delta dental insurance company. With the deltacare usa plan, you select a primary care dentist from the deltacare usa network at the time of enrollment. Save this booklet for reference this booklet explains benefit provisions that are specific to a dental plan administered by the washington state health care authority. Deltacare usa basic and delta dental ppo basic plans. You may request electronically a list of your benefits by submitting the online customer service request for deltacare usa. Elevate your smile deltacare usa university health plans. Review your plan booklet for more information and talk to your dentist about your options. Members select a dentist from the deltacare usa network, who provides all primary dental services for their family and coordinates.
Benefits information delta dental for individuals and families. Deltacare usa dental hmo program this booklet is a combined evidence of coverage and disclosure form eoc for your deltacare usa dental hmo program program provided by delta dental of california delta dental. To find the most current listing of deltacare usa dental offices. The deltacare usa individual dental program offered by delta dental of california provides comprehensive hmo dental care through a convenient.
Refer to your plan booklet for details about your outofnetwork benefits. Please refer to your plan booklet for specific details about your plan. This booklet is a combined evidence of coverage and disclosure form eoc for your. Deltacare usa frequently asked questions delta dental. The monthly premiums for the deltacare usa and dental dental ppo plans will decrease for the 2012 plan year. Group name dental plan combined evidence of coverage and disclosure plan pgecadc19 1 introduction we are pleased to welcome you to the deltacare usa dental plan. Welcome to deltacare deltacare is an innovative dental plan that provides you with comprehensive care at a significantly lower cost than most other dental planswhich means great value for you. Deltacare usa provided by delta dental of california. Members select a dentist from the deltacare usa network, who provides all primary. A participating dentist will be assigned to you after enrollment. As long as the dentist is part of the deltacare usa network and is accepting patients, you may select the facility as your primary dentist. Dental insurance university of california, san diego. How to use the deltacare usa plan choice of contract dentist.
Later you may request to change dentists, but services are covered only when you visit a deltacare provider. Deltacare works much like a dental hmo, in which you and. Deltacare usa plan highlights delta dental for individuals. Your employer has chosen to participate in the exchange, and you have selected delta dental of california to meet your dental insurance needs. Or scgastd welcome to deltacare usa quality, convenience, predictable costs deltacare usa is a dental program that provides you and your family with quality dental bene. My dentist is a delta dental dentist but is not on the list of deltacare usa. This booklet is a combined evidence of coverage and disclosure form eoc for your deltacare usa dental hmo programprogram provided by delta dental of california delta dental. Offered through delta dental insurance company, the deltacare usa program is designed to encourage you and your. Deltacare usa contract dentist after your plan effective date.
Please refer to schedule b for further clarification of benefits. You also may contact deltacare usa customer service at 8004224234. Orthodontic treatment in progress deltacare usa has an orthodontic treatmentinprogress provision that allows new enrollees to. Below are brief descriptions of the three kinds of dental plans. Deltacare usa basic and delta dental ppo basic plans benefits.
When you enroll in the deltacare usa dental health plan, many services cost nothing, while some require a copayment. It includes networks of dentists which can save you money. Plan ca11b deltacare usa description of benefits and copayments. Upon enrollment, enrollees will receive a plan booklet with defined copayments for covered services.
Plan ahead and stick to your budget with deltacare usa, an hmotype plan. When you enroll, you select a contract dentist to provide services. The plan offers fixed copayments for exams and procedures and you will choose a network dental provider. Currently, premiums are paid by the csu, with no cost to the employee. Deltacare offers members simplicity and value deltacare is an innovative dental plan that provides you with comprehensive care at a significantly lower cost than most other dental planswhich means great value for you. You will pay an office visit fee and the listed copayment for the covered procedures you receive. Enjoy minimal or no copayments for preventive care and choose from a network of dentists to manage your dental needs. Plan cad48 deltacare usa description of benefits and copayments schedule a description of benefits and copayments the benefits shown below are performed as deemed appropriate by the attending contract dentist subject to the limitations and exclusions of the program. Find a deltacare usa dentist select from among the many conveniently located deltacare usa contracted general dentists. Many deltacare usa plans have no exclusions for preexisting conditions, including missing teeth. Also included in this packet are the name, address. High plan deltacare usa dhmo code description enrollee pays d0100d0999 i. How to access plans and pricing can be found on the delta dental website. A prepaid plan requires you and your eligible dependents to use a dentist from a specific list of dentists who are located in california and who contract with your selected prepaid carrier.
Deltacare usa dhmo standard miamidade county public. Your deltacare usa plan covers treatment started and completed only after your plan s effective date of coverage. In most states, enrollees must select a primary care dentist in the deltacare usa network in order to receive treatment, as in a traditional hmo. Deltacare usa is a prepaid hmostyle dental plan that contracts with more than 3,800 general and specialty dentists in the deltacare network in california. When there are more than six crowns in the same treatment plan, an enrollee may. Deltacare usa provided by delta dental of c alifornia we. Deltacare usa provided by delta dental of c alifornia. The program has been established and is administered in accordance with the provisions of a group dental service contract contract issued by delta dental. The program has been established and is administered in. This booklet is a combined evidence of coverage and. Ddwa developed the deltacare program to address rising health care costs. This is a summary or brief description of the features of the kaiser foundation health plan of georgia, inc.
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