Dental coverage, offered through Delta Dental of Tennessee, is bundled with your medical/vision/hearing coverage. The plan provides 100% coverage for preventive care when you use Delta Dental providers. It covers restorative services after you meet an annual deductible, as well as orthodontia for your covered children under age 19.
How the plan works
You can see any dentist you choose, but dental benefits are highest when you choose a provider in the Delta Dental Premier or PPO networks. That’s because Delta Premier and PPO dentists have agreed to a lower contracted fee for services, so the percentage of the charge you pay is based on this lower contracted fee. For a list of providers or for more information about the plan, call 1-800-223-3104 or visit deltadentaltn.com/mnps. On the website, you’ll find a consumer toolkit where you can order ID cards, view claims and find dental health information.
If you choose to go to a non-Delta provider and charges exceed the contracted amount (called the Maximum Plan Allowance, or MPA), you must pay your coinsurance plus the amount exceeding the MPA.
Only new enrollees will receive a dental ID card. You may present your card when seeking care/services or simply identify yourself as a member.
If your dentist recommends a course of treatment that is expected to cost $300 or more, you should ask your dentist to file for a pre-treatment estimate of benefits. This helps you avoid surprises by letting you know how much is payable for the proposed treatment before it begins.
Dental benefits … at a glance
The chart below provides an overview of dental benefits. Rules and limitations apply; see the plan doc for more details. Click on chart to view or download a pdf file.
Prevention is the key to a healthy smile! Preventive dental care is covered at 100% when you use network providers, with no deductibles or copays. Each covered family member can receive x-rays and up to two exams/cleanings a year.