Delta Dental Plan Details
Group Number:
33420-1
33420-2 - Insurance
Website:
Support:
1.800.544.0718
Claim Submission Address:
Delta Dental of Iowa
PO Box 919
Ankeny, IA 50021-0919
The Delta Dental plan pays all or a portion of the reasonable and customary costs of covered dental services, up to a maximum annual benefit of $1,500 per person.
The plan provides benefits for:
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Preventive and diagnostic care, such as routine check-ups, x-rays and cleanings — covered at 100% in-network and out of network (up to reasonable and customary limits)
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Basic care, such as fillings, extractions, periodontal treatment, oral surgery, root canal, repairs to crowns, bridges, and dentures
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Major care, such as implants, inlays, onlays, and installation of crowns, dentures and bridgework
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Orthodontia for your dependent children under the age of 19
Before you can receive benefits for certain services, you must meet the annual deductible ($25 per person, $75 per family). The deductible does not apply to preventive and diagnostic services, or to orthodontia.
The Delta Dental plan includes network providers, which vary depending on where you live. If you use a network provider, you may pay a percentage of a discounted fee, which saves you money.
If you use a non-network provider, your reimbursement will be based on reasonable and customary limits. To review a list of In-Network providers, visit www.deltadentalia.com and review their PPO Network listing.
For online access to a breakdown of your benefits and eligibility, claim detail information, or to print a copy of your ID card, use this step-by-step guide to register on their site.