Dental

Evoque’s dental plans are offered through Delta Dental. Under the plans, you can access care in three ways: in-network, premier network (providers who have agreed to Delta Dental pricing guidelines, though still out-of-network) or out-of-network. It is to your advantage to go to an in-network dentist because typically your out-of-pocket expenses will be lower. You can find in-network dentists at www.deltadentalins.com.

COMPARING DENTAL PLAN OUT-OF-POCKET EXPENSES

The following example illustrates three participants who receive the exact same treatment for Major Care.

  • Participant #1 uses an in-network provider.
  • Participant #2 uses a Premier provider.
  • Participant #3 goes out-of-network.

All participants have already met their deductible.

Participant #1: In-Network

  • Dentist Charges: $100
  • Delta’s Maximum Allowable PPO Rate: $70
  • Plan Pays 60% of Maximum Allowable PPO Rate: $28
Participant #1 Pays: $28

Participant #2: Premier

  • Dentist Charges: $100
  • Delta’s Maximum Allowable Premier Rate: $85
  • Plan Pays 50% of Maximum Allowable Premier Rate: $42.50
Participant #2 Pays: $42.50

Participant #3: Out-of-Network

  • Dentist Charges: $100
  • Prevailing Charge: $75
  • Plan Pays 50% of Prevailing Charge: $37.50
Participant #3 Pays: $37.50

Cost Estimator from Delta Dental

The Delta Dental Cost Estimator is a tool that allows you to estimate costs for typical dentist visits before arriving at the dentist’s office. The Cost Estimator shows the projected cost of an entire dentist visit rather than just a single procedure. You can also select multiple dentists, both in- and out-of-network, to compare costs and savings.

You can see your current benefits balance showing accruals toward any deductible, maximums and benefit limitation. If you’re a Delta Dental plan member, simply visit www.deltadentalins.com and log in.

SmileWay Wellness Benefits

If you have been diagnosed with Diabetes, Heart Disease, HIV/AIDS, Rheumatoid Arthritis, or a Stroke, your dental plan offers expanded coverage, at no cost to you.

Opting in to this expanded coverage will give you these added benefits per plan year:

  • One periodontal scaling and root planning procedure per quadrant per plan year, covered at 100%
  • Four of the following (any combination) per plan year, covered at 100%:
    • teeth cleaning
    • periodontal maintenance procedure
    • scaling in presence of moderate or severe gingival inflammation

To opt in, log in to your online account at www.deltadentalins.com, click on the Optional Benefits tab in the left column and then select Opt In.

For more information, contact Delta Dental at www.deltadentalins.com or 800-932-0783.