Be prepared: By requesting a Predetermination of Benefits, you can find out from Delta Dental how much the Plan will cover for your dental procedure and how much you will be required to pay.

 

In order to help you avoid any large, unexpected dental bills, if your Dentist expects that the course of treatment recommended will exceed $300, you should ask your Dentist to submit to Delta Dental the treatment plan that describes each procedure necessary to fully complete treatment before starting any dental work. Delta Dental will review the information to determine how much the Fund will pay.

This Predetermination of Benefits is a convenience to let you know in advance what portion of the cost of your dental treatment will be your responsibility. Delta Dental will respond directly to your Dentist with its decision as to whether or not the dental treatment will be covered and how much will be paid. The Predetermination of Benefits is also available if your Dentist is not participating in the Delta Dental Plan.

This Predetermination of Dental Benefits is not a guarantee of coverage. It is intended to let you know in advance what portion of the cost of your dental treatment will be your responsibility.