Frequently Asked Questions
Answers to your questions about Delta Dental's Individual plans.
Answers to the most frequently asked questions about Delta Dental of Wisconsin Individual plans are provided below. Simply click on a question to view the answer. Links throughout the answers will guide you to further information on our website. Should you have any further questions, please contact an Individual Plan Specialist by calling toll-free 888-899-3729, Monday through Friday, 8:00 a.m. to 4:30 p.m.
- » Who is eligible to purchase Delta Dental of Wisconsin's individual plans?
- » Do I have coverage outside of Wisconsin?
- » What if I permanently move out of Wisconsin?
- » How do I enroll?
- » When will my dental policy be effective?
- » How can I cancel my policy?
- » How long are the rates guaranteed?
- » Are there services that are not covered?
- » Is treatment for a missing tooth immediately covered?
- » How can I find out if my dentist is part of the Delta Dental network?
- » What is the difference between the Enhanced and Standard plan options?
- » Do I have to see a Delta Dental network dentist?
- » Where can I find my complete Plan information?
- » Who should I contact with questions about my coverage?
Who is eligible to purchase Delta Dental of Wisconsin's individual plans?
The Delta Dental individual policy is available to all permanent residents of Wisconsin who do not have access to a Delta Dental of Wisconsin group plan from their place of employment. For eligible individuals, coverage is also available for your spouse and/or dependent children. (Children are eligible to age 26). Coverage types are: Single, Two-Person and Family. The two-person policy can be for you and your spouse or dependent child.
Do I have coverage outside of Wisconsin?
Yes, your Delta Dental coverage travels with you. Common examples are:
- » A secondary residence outside of Wisconsin.
- » Full-time students attending college in another state.
- » Traveling outside the state of Wisconsin, including international travel.
What if I permanently move out of Wisconsin?
Your coverage would terminate at the end of the month in which you changed residency. Plans are open to Wisconsin residents only, which means that you must reside in Wisconsin at least six months of the year.
How do I enroll?
The easiest way is to enroll online in just three easy steps. You may also download an application that you can print, complete and mail back to Delta Dental. To request an application be mailed to you, call 888-899-3729.
When will my dental policy be effective?
Your policy will be effective on the first day of the month following approval of your application.
How can I cancel my policy?
When your plan initially becomes effective, you may cancel by notifying Delta Dental within ten days of receiving your policy and any premium paid will be refunded to you less claims that Delta Dental has paid. After the initial ten-day period, you can terminate the policy by sending written notice to Delta Dental at any time. The policy will end as of the last day of the monthly renewal period during which Delta Dental receives your notice. You must still pay the premium for coverage provided during that renewal period. If you cancel your policy, or if your coverage is terminated for any reason, you may not re-enroll in the plan for 24 months.
How long are the rates guaranteed?
We will provide you with at least 30 days notice of any rate change.
Are there services that are not covered?
Yes, an example of a service that is not covered is orthodontics. There is no orthodontic coverage available with any of the individual plans. See your policy for a complete list of exclusions or view an overview of Exclusions & Limitations.
Is treatment for a missing tooth immediately covered?
If you lose a tooth through accident or injury, you are immediately covered for emergency treatment to relieve pain. However, for replacement of teeth that have been missing for some time through the use of bridges or dentures, there is a 12-month benefit waiting period. The waiting period is waived if you had coverage under a Delta Dental of Wisconsin plan within 60 days of your enrollment in the individual plan.
How can I find out if my dentist is part of the Delta Dental network?
The easiest and most up-to-date listings can be found through our online dentist search tool. Under Product Selection, choose "Delta Dental PPO." You can search for dentists by their last name, practice name, or specialty. Results can be sorted by name, practice name, or driving distance and your list can be printed, e-mailed, or viewed in a PDF file.
To access our dentist directories from a touch-tone phone, call 800-236-3712 and follow the automated instructions. Participating dentists are searched by ZIP code. The name, address, and phone number for each dentist will be listed in alphabetical order.
What is the difference between the Enhanced and Standard plan options?
The biggest difference is in the co-insurance levels (the percentage that Delta Dental pays) for various services. For example, with the Enhanced Plan, routine exams, cleanings and x-rays are covered at 100%, with no deductible. Under the Standard Plan, those services are covered at 80%, and the patient must first pay a deductible. Please refer to the benefit summary for complete information about each plan option.
Do I have to see a Delta Dental network dentist?
You may see any dentist you wish. However, there are many advantages to seeing a dentist who is a member of the Delta Dental PPO or Delta Dental Premier networks. The table below illustrates these advantages.
Where can I find my complete Plan information?
Complete plan information will be mailed to you shortly after you enroll in the plan.
Who should I contact with questions about my coverage?
For answers to any questions you may have about Delta Dental's individual dental plans, call us at 888-899-3729.
Need additional guidance?NEED ASSISTANCE? An Individual Plan Specialist is standing by: call toll-free 888-899-3729, Monday through Friday, 8:00 a.m. to 4:30 p.m. |