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How often can I have my teeth cleaned?
One cleaning is covered every 6 months.
Are cosmetic procedures covered?
This plan does not cover cosmetic procedures.
Is Orthodontia Covered?
Yes. This plan has a $1,000 lifetime maximum for orthodontic procedures.
Benefits are limited to $350 per calendar year and a separate $100
lifetime deductible applies.
Do I need to obtain claim forms?
While most dentists will file the claim for you, all of Delta Dental’s
Network Providers have agreed to file the claim for any of Delta Dental’s
insured’s. However, if services are rendered by a non-network provider,
and they will not file the claim on your behalf, you must obtain a
claim form and file the claim yourself.
Is there a waiting period?
Yes, there are some waiting periods with this plan.
Is this insurance?
Yes.
Can I change my dentist once I am in the plan?
Yes, you may change your dentist at any time.
If my dentist isn't currently in the directory, what can I do?
What is the deadline for enrollments?
All applications must be submitted by the 20th of the month to receive
a 1st of the following month effective date.
When will I receive my enrollment package and what will it include?
You will receive your enrollment package upon completion of enrollment
and payment of applicable premiums/enrollment fees, or a few days prior
to the selected effective date. The enrollment package will include
your Certificate of Coverage and I.D. cards.
What should I expect to see on my Bank /Credit Card Statement for
my premium payments?
Morgan-White Draft Trust will appear on your statement as the charge
for your premiums.
Is the processing fee billed separately or with the premium?
All fees are included in the premium.
Can I change my payment type from monthly to another available option
once I am in the plan?
Yes.
What if I need to make changes to my coverage (example: add or remove
a dependent/spouse)?
You can call MorganWhite at 1-800-800-1397, select option 4.
Who is eligible for coverage under this plan?
Any individuals who are 18 years of age or older, and their eligible
dependents (unmarried children from birth to age 26).
What are my options for selecting an Effective Date?
Plan effective dates are always the FIRST of the month. Incomplete enrollment
forms or failure to submit the required initial premium amount may cause
an initial delay in issuance of insurance. We advise you not to cancel
any other insurance or assume you are insured under the Plan until you
receive your Certificate of Coverage.
Will I be able to cancel the dental plan after I have enrolled?
Yes, the policy may be canceled with 30 days written notice.
Does this plan have any Limitations or Exclusions?
Yes. There are some limitations and exclusions with this plan, as with
most any insurance policy. Below is a brief summary of the limitations
and exclusions associated with this plan. A complete list of plan benefits,
limitations and exclusions is included in the Certificate of Coverage.
Optional Services - Services that are more expensive than the form of
treatment customarily provided under accepted dental practice standards
are called "Optional Services." Optional Services also include
the use of specialized techniques instead of standard procedures. For
example:
(a) A crown where a filling would restore the Tooth
(b) A precision denture/partial where a standard denture/partial could
be used;
(c) An inlay/onlay instead of an amalgam restoration;
(d) a composite/resin restoration instead of an amalgam restoration on
posterior teeth.
If you receive Optional Services, your Benefits will be based on the
lower cost of the customary service or standard practice instead of the
higher cost of the Optional Service. You will be responsible for the
difference between the higher cost of the Optional Service and the lower
cost of the customary service or standard practice.
Delta does not pay Benefits for:
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Services for injuries or conditions which are compensable under workers'
compensation or employers' liability laws
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Services which are provided to the Enrollee by any federal or state
government agency or are provided without cost to the Enrollee by
any municipality, county or other political subdivision except as
such exclusion maybe prohibited by law.
- Services with respect to congenital (hereditary) or developmental
(following birth) malformations or cosmetic surgery or dentistry
for purely cosmetic. Reasons, include but are not limited to:
o cleft palate,
o maxillary and mandibular (upper and lower jaw) malformations,
o enamel hypoplasia (lack of development),
o fluorosis (a type of discoloration) of the teeth,
o andontia (congenitally missing teeth),
o except those services provided to newborn children for congenital
defect or birth abnormalities or services that may be provided under
Orthodontic Benefits.
o Services for restoring tooth structure lost from wear, erosion,
or abrasion,
o for rebuilding or maintaining chewing surfaces due to teeth out
of alignment or occlusion, for stabilizing the teeth. Such services
include, but are not limited to: equilibration, periodontal splinting,
occlusaladjustment.
o Any Single Procedure started prior to the date the person became
covered for such services under this program.
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Prescribed drugs, medication or analgesia.
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Experimental procedures.
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Charges by any hospital or other surgical
or treatment facility and any additional fees charged by the Dentist
for treatment in any such facility.
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Charges for anesthesia, other than by a licensed Dentist for administering
general anesthesia in connection with covered oral surgery services.
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Extra oral grafts (grafting of tissues from outside the mouth to
oral tissues).
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Services with respect to any disturbance of the temporomandibular
joint (jaw joint).
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Services performed by any person other than a Dentist or auxiliary
personnel legally authorized to perform services under the direct
supervision of a Dentist.
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Replacement of teeth extracted prior to the
member's effective date.
Disclaimer
This is a summary of the features and benefits included in the Delta
Dental Insurance Company group dental plan issued to Benefits Association,
Inc. When you purchase the plan you will receive a Certificate of Coverage
that details your rights and obligations, as well as those of the insurance
company.
This website provides a brief description of some of the important
features of this plan. It is not the insurance contract. A full description
of benefits, exceptions and limitations is contained in the Certificate
of Coverage that will be issued upon completion of enrollment and receipt
of applicable premiums and or enrollment fees.
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