You may seek care from almost any dentist you wish. However, there are usually advantages when you receive services from PPO Dentists or Participating Delta Dental Dentists.
Dental II Plan Documents
How much you pay for Covered Services depends on the benefit category of the service you receive and the dentist you receive services from. It is most often to your financial advantage to receive services from a PPO Panel Dentist or a Participating Delta Dental Dentist.
Delta Dental of Iowa has contracts with PPO Dentists throughout the state of Iowa.
- PPO Dentists agree to accept their local Delta Dental Member Company's PPO Schedule, resulting in savings.
- Your deductible or coinsurance responsibility may be less for covered services your receive from a PPO versus a Participating Delta Dental Dentist or a nonparticipating dentist.
- PPO Dentists agree to file claims for you.
- Delta Dental of Iowa settles claims directly with PPO Dentists.
Participating Delta Dental Dentists:
Delta Dental of Iowa has contracting relationships with Participating Delta Dental Dentists throughout the state. The contracts with Participating Delta Dental Dentists include payment arrangements based on Delta Dental’s Maximum Plan Allowance.
- Participating Delta Dental Dentists agree to accept their local Delta Dental Member Company’s payment arrangement, resulting in savings.
- Your deductible or coinsurance responsibility may be more for Covered Services you receive from a Participating Delta Dental Dentist who is not a PPO Dentist.
- Participating Delta Dental Dentists agree to file claims for you.
- We settle claims directly with Participating Delta Dental Dentists.
When you receive services from non-participating (non-par) dentists, you will not receive any of the advantages that Delta Dental of Iowa's contracts with PPO Dentists or Participating Delta Dental Dentists offer. As a result, when you receive services from non-participating dentists, all of the following statements are true:
- Delta Dental of Iowa does not have contracting relationships with non-participating dentists. They do not agree to accept their local Delta Dental Member Company’s PPO 9 payment arrangement or any other payment arrangement. This means you are responsible for any difference between your nonparticipating dentist’s billed charge and the PPO Schedule or the Maximum Plan Allowance, as the case may be.
- Non-participating dentists are not responsible for filing your claims.
- We settle claims with you, not non-participating dentists. You are responsible for paying your dentist in full, including any deductible, coinsurance, and non-approved charges you may owe.
- Non-participating dentists may charge for “infection control,” which includes the costs for services and supplies associated with sterilization procedures. You are responsible for any extra charges billed by a non-participating dentist for “infection control. Find more information in the Dental II coverage manual.
College of Dentistry
To increase educational opportunities for third and fourth-year dental students, the College of Dentistry and University Benefits created the Student Dental Clinics Incentive (for Dental II and House Staff Dental participants).
ABOUT OUR SITE:
Our website's information describes only the highlights of the plans and does not constitute official plan documents. Additional terms and conditions may apply. If there are any discrepancies between the information contained herein and the official plan documents, the plan documents will govern. For more detailed information, you may contact Delta Dental of Iowa at number 800-544-0718 (TTY: 888-287-7312), Monday through Friday from 7:30 a.m. to 5:00 p.m. (central time). For more efficient service, please have your member ID number handy - you can find it on the front of your card.