Personalized Benefits Information
If you're wondering when you can get your teeth cleaned again, or how dental procedures are covered, you can log into the Consumer Toolkit® using the "Quick Links" menu on this page, and find out. With 24/7 access, you can get the information you need with the convenience you want.
Your Benefits at a Glance.
The chart below illustrates the dollar amount of coverage paid by Delta Dental when you see a TRDP network dentist for care. The percentage paid by Delta is based on the allowed amount for each procedure, which is what a network dentist will charge you. While the coverage percentage is the same for all TRDP patients, total out-of-pocket costs will most likely be higher if care is received from a non-network or overseas dentist.
Still covered by the Basic program? Review your benefits and consider upgrading.
|Benefits||Delta Dental Pays|
|Benefits available during the first 12 months of enrollment:|
|Diagnostic services(exams, x-rays)1||100%|
|Preventive services(cleanings, fluoride treatments)2||100%|
|Basic restorative services(fillings, including tooth-colored fillings on back teeth)||80%|
|Endodontics (root canals)||60%|
|Periodontics (gum treatment)||60%|
|Oral surgery (extractions)||60%|
|Emergency services ( treatment for minor pain)3||80%|
|Dental accident coverage||100%|
|Additional services available after 12 months of continuous enrollment or if enrolled within four months after retirement:|
|Major restorative services (cast crowns, onlays and bridges)||50%|
|Prosthodontic services (partial/full denture)s4||50%|
|Dental implant services||50%|
|Deductibles and Maximums6|
|Annual deductible (per person, $150 cap per family, per benefit year)||$50|
|Annual maximum (per person, per benefit year)||$1,300|
|Orthodontic maximum (per person, per lifetime)||$1,750|
|Dental accident maximum (per person, per benefit year)||$1,200|
|Benefit year: January 1 – December 31|
|*The percentage paid by Delta is based on the allowed amount for each procedure. While the coverage percentage is the same for all TRDP patients, total out-of-pocket costs may be higher if care is received from a non-network or overseas dentist.|
|Covered benefits are subject to certain limitations. For more information on all covered services and detailed information on benefit levels, limitations, exclusions, program policies and payments for non-network and overseas dentists, please see the Enhanced Program Benefits Booklet.|
|1Payment for a complete set of x-rays (procedure D0210) is limited to once within a 48 month period even if you change dentists. It is customary to request that your new dentist obtain a copy of your dental records, including x-rays from your previous dentist to help in establishing your patient records with the new dentist.|
|2Two cleanings are covered in a rolling, consecutive 12-month period (not the same as a calendar year). For example, if coverage was provided for a cleaning performed on March 2, 2015, and August 24, 2015, then coverage for this procedure will be available again on or after March 2, 2016. Use the online Consumer Toolkit to help you track your cleanings to date and when you’re eligible for your next one.|
|3Emergency benefits can involve a limited oral exam and/or minor procedures necessary to treat the pain associated with the emergency. Emergency services covered under the TRDP are payable at two different benefit levels. For example, an emergency exam (procedure D0140) is payable at 100% and emergency treatment of pain (procedure D9910) is payable at 80%. Both procedures are subject to the annual deductible and maximum.|
|4After a 12-month commitment TRDP will cover 50% of the allowed amount (up to an annual maximum of $1,300) for new, complete upper and lower dentures. If new dentures need to be replaced at a later date, replacement of either a removable or fixed denture that cannot be made serviceable is covered after five years.|
|5After a 12-month enrollment commitment, you are eligible for orthodontics. The TRDP lifetime maximum for orthodontics per person is $1,750 payable at 50% of the allowed amount benefit level. Delta Dental will make an initial payment of 25% of the total amount payable and three automatic progress payments at six-month intervals, or less if active treatment is less than 18 months. For treatment in-progress we prorate the amount based on how many months of treatment remain. Complete information can be found in the Benefits Booklet.|