2
Are my benefits the same? Yes, coverage is the same, with no change to deductibles or maximums. How do I find an in-network dentist? Visit deltadentalins.com/amgen to search for a Delta Dental PPO dentist in your area. Under your plan, you can visit any licensed dentist and receive benefits, but you’ll save most when you visit a PPO dentist. Where’s my ID card? You don’t need one. Just tell the dental office you’re covered under Delta Dental of California, and provide your name, birthdate and enrollee ID or social security number. Family members covered under your plan can provide your details. If you prefer to carry a dental plan ID, you can print one out at deltadentalins.com/amgen or Delta Dental PPO SM What you need to know about transition of care Welcome to Delta Dental pull up an electronic ID on your smartphone. Just visit the website or download the Delta Dental app from the Delta Dental Plans Association. What if I’m in the middle of dental work? Here’s how payment is determined: Root canals: If you started treatment before Jan. 1, 2018, your previous plan is responsible for any later treatment. • Crowns: If the crown is placed on or after Jan. 1, 2018, it is covered by Delta Dental. • Orthodontics: Your previous carrier will pay for treatment before Jan. 1, 2018, and Delta Dental will cover treatment starting Jan. 1. Coverage will be prorated based on remaining services and costs as of Jan. 1. See the example on the next page to see how the bill breaks down. Your Amgen dental carrier will transition from Aetna to Delta Dental of California Jan. 1, 2018. This is your effective date of coverage. In general, procedures started before this date are the responsibility of Aetna, while procedures started on or after this date are handled by Delta Dental. We keep you smiling® deltadentalins.com/amgen

Welcome to Delta Dental - Amgenamgenbenefits.com/Documents/Amgen - Delta Dental Transition.pdf · You don’t need one. Just tell the dental office you’re covered under Delta Dental

  • Upload
    others

  • View
    1

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Welcome to Delta Dental - Amgenamgenbenefits.com/Documents/Amgen - Delta Dental Transition.pdf · You don’t need one. Just tell the dental office you’re covered under Delta Dental

Are my benefits the same?Yes, coverage is the same, with no change to deductibles or maximums.

How do I find an in-network dentist?Visit deltadentalins.com/amgen to search for a Delta Dental PPO dentist in your area. Under your plan, you can visit any licensed dentist and receive benefits, but you’ll save most when you visit a PPO dentist.

Where’s my ID card?You don’t need one. Just tell the dental office you’re covered under Delta Dental of California, and provide your name, birthdate and enrollee ID or social security number. Family members covered under your plan can provide your details.

If you prefer to carry a dental plan ID, you can print one out at deltadentalins.com/amgen or

Delta Dental PPOSM

What you need to know about transition of care

Welcome to Delta Dental

pull up an electronic ID on your smartphone. Just visit the website or download the Delta Dental app from the Delta Dental Plans Association.

What if I’m in the middle of dental work?Here’s how payment is determined:

• Root canals: If you started treatment before Jan. 1, 2018, your previous plan is responsible for any later treatment.

• Crowns: If the crown is placed on or after Jan. 1, 2018, it is covered by Delta Dental.

• Orthodontics: Your previous carrier will pay for treatment before Jan. 1, 2018, and Delta Dental will cover treatment starting Jan. 1. Coverage will be prorated based on remaining services and costs as of Jan. 1. See the example on the next page to see how the bill breaks down.

Your Amgen dental carrier will transition from Aetna to Delta Dental of California Jan. 1, 2018. This is your effective date of coverage. In general, procedures started before this date are the responsibility of Aetna, while procedures started on or after this date are handled by Delta Dental.

We keep you smiling® deltadentalins.com/amgen

Page 2: Welcome to Delta Dental - Amgenamgenbenefits.com/Documents/Amgen - Delta Dental Transition.pdf · You don’t need one. Just tell the dental office you’re covered under Delta Dental

Copyright © 2017 Delta Dental. All rights reserved. PPO _Amgen #106083 (rev. 07/17)

Delta Dental PPO is underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA — Delta Dental of California; PA, MD — Delta Dental of Pennsylvania; NY — Delta Dental of New York, Inc.; DE — Delta Dental of Delaware, Inc.; WV — Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a Dental Provider Organization (DPO) plan.

Example

How Delta Dental prorates in-progress orthodontic treatmentAssume you began 18-month orthodontic treatment under Aetna on July 1, 2017, and the total cost of treatment is $4,500. Your coverage switched to Delta Dental on Jan. 1, 2018. Orthodontics is covered at 50%, and your lifetime orthodontic maximum is $2,000.

1. First, figure out the cost per month. Divide the total cost of treatment by the number of months. $4,500 ÷ 18 months = $250 per month

2. Then, count how many months of treatment occurred under the previous plan. July 1, 2017 to Jan. 1, 2018 = 6 months

3. Calculate the cost of treatment under the previous plan. Multiply the number of months (Step 2) by the cost of treatment per month (Step 1). 6 months x $250 = $1,500

4. To figure out Delta Dental’s portion, first subtract the cost under the previous plan (Step 3) from the total fee. $4,500 - $1,500 = $3,000

5. Then, multiply by the rate of coverage (50%). $3,000 × 50% = $1,500

6. Is this amount under the $2,000 orthodontic lifetime maximum? If yes, this is the amount Delta Dental will pay. (If it’s $2,000 or more, Delta Dental will pay $2,000.) Yes: $1,500

7. You pay the remaining amount. Subtract the amount covered by the previous plan (Step 4) from Delta Dental’s portion (Step 6). $3,000 - $1,500 = $1,500

Does my orthodontic lifetime maximum carry over from Aetna?No, your orthodontic maximum will reset to $2,000. That means added savings for in-progress orthodontic treatment.

I have more questions. Who should I contact?For more information, visit deltadentalins.com/amgen or call Customer Service toll-free at 800-765-6003.