Using the Dental Plan
ID Cards
Delta Dental issues an identification card which you provide at the time of service. If you lose your ID card, contact Delta Dental.
Network
The Delta Dental plan offers a nationwide network of participating providers that includes over 95% of dentists in Missouri. You may choose network or non-network providers for treatment. Your out-of-pocket costs may be less when using a network dentist.
Reimbursement
Network providers are reimbursed based on what Delta Dental determines to be the usual, customary and reasonable (UCR) fee for services and accept the UCR amount as payment in full. When you use a network provider, the provider will file claims for you and will not bill you for any amount that exceeds the UCR amount. You are responsible for any applicable deductible, coinsurance amount or amount over your annual maximum (per person). You are also responsible for any procedures not covered by the dental plan.
Visit Delta Dental's Web site to locate participating providers near you. If you use a non-network provider, it is your obligation to make full payment to the dentist and file your own claim form. Delta Dental reimburses covered expenses. The dentist may bill you for expenses above the amount Delta Dental reimburses. If you go to a non-participating provider in Missouri, Delta Dental pays you directly based on the provider’s fee or the prevailing fee, whichever is less. If you go to an out-of-state non-participating provider, Delta Dental will pay you directly on the same basis as the local Delta Dental plan reimburses its non-participating dentists.