Preparing for orthodontic treatment under your DeltaCare USA plan? Start by reviewing these
FAQs. Then, log in to your online account at deltadentalins.com to review your coverage.
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Getting started
1. Do I need a referral to begin orthodontic treatment?
Yes. You should see your DeltaCare USA primary care dentist for a referral to a DeltaCare USA
orthodontist. If your plan requires pre-authorization of orthodontic treatment, your DeltaCare
USA orthodontist will submit the paperwork for you.
2. How do I find a DeltaCare USA orthodontist?
Use the “Find a Dentist” tool at deltadentalins.com to search for a DeltaCare USA network
orthodontist near you. Select “DeltaCare USA” as your network and enter “orthodontist” in the
keyword field. You can also ask your primary care dentist for a recommended orthodontist in
the DeltaCare USA network or call Customer Service at 800-422-4234 for help.
Orthodontic coverage
3. What’s covered?
Coverage varies depending on your plan,
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but most DeltaCare USA plans include:
• Pre-orthodontic treatment exam
• Treatment planning session
• Pre- and post-treatment records (x-rays and study models)
• Limited, interceptive and comprehensive orthodontic treatment
• Retention (including retainers)
It is less common for plans to cover:
• Appliances to correct harmful habits like thumb-sucking
• Jaw surgery to facilitate orthodontic treatment
• Treatment to prepare for any non-covered surgical procedures
Get the Facts
Straight
Find out about orthodontic benefits
DeltaCare® USA
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Your benefits may differ from the general information provided here. Review your plan booklet for specific details
regarding orthodontic coverage under your plan.
deltadentalins.com/enrollees
4. Are retainers covered?
One set of post-treatment retainers is covered. If your plan covers two-phase orthodontic
treatment, retainers are usually covered after each phase.
5. Is Invisalign® covered?
Invisalign and other specialty appliances are considered optional treatments, and will result in
additional fees. If you’re interested in Invisalign, ask your dentist to provide an estimate of your
out-of-pocket costs before you begin treatment.
Managing costs
6. How much does orthodontic treatment cost?
Costs depend on the services you need. At your first appointment, your orthodontist will
give you an initial estimate of costs. If you choose to proceed, the orthodontist will create a
treatment plan and present you with the associated copayments and fees. To find out your
orthodontic copayment amounts, see the orthodontics section of your plan booklet, or log in
to your online account at deltadentalins.com.
7. If I began treatment under a dierent dental plan, is work in progress covered?
Work in progress coverage depends on your plan and applies only if you are in active treatment
(banding has taken place).
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Most DeltaCare USA plans allow you to continue treatment started
under a previous dental plan. You can visit the same orthodontist, with the same coverage and
copayments as your previous plan.
If banding has not occurred, you are not eligible for continuous orthodontic coverage. In that
case, you must visit a DeltaCare USA orthodontist and pay the copayments listed in your
DeltaCare USA plan booklet.
8. What if I’m just starting orthodontic treatment?
You’ll begin by asking your DeltaCare USA primary care dentist for a referral to a DeltaCare USA
orthodontist.¹ Your copayments are listed in your DeltaCare USA plan booklet.
9. Are claims required for orthodontic treatments?
No. Simply pay your copayment for covered services directly to your DeltaCare USA
orthodontist.
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10. How do I sign up for continuous coverage?
Download the DeltaCare USA Continuous Orthodontic Coverage form from
deltadentalins.com/deltacare and give it directly to your orthodontist. Your orthodontist will
complete the form and mail it to the DeltaCare USA claims department, along with the required
supporting documents. Your orthodontist can also access the form directly from the Provider
Tools Reference Library on our website.
DeltaCare USA is underwritten in these states by these entities: AL — Alpha Dental of Alabama, Inc.; AZ — Alpha Dental of Arizona, Inc.; CA — Delta
Dental of California; AR, CO, IA, MA, ME, MI, MN, NC, ND, NE, NH, OK, OR, RI, SC, SD, VA, VT, WA, WI, WY — Dentegra Insurance Company; AK, CT, DC,
DE, FL, GA, KS, LA, MS, MT, TN, WV — Delta Dental Insurance Company; HI, ID, IL, IN, KY, MD, MO, NJ, OH, TX — Alpha Dental Programs, Inc.; NV — Alpha
Dental of Nevada, Inc.; UT — Alpha Dental of Utah, Inc.; NM — Alpha Dental of New Mexico, Inc.; NY — Delta Dental of New York, Inc.; PA — Delta Dental
of Pennsylvania. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. These companies are financially responsible
for their own products.
West Virginia: Learn about our commitment to providing access to a quality dentist network at deltadentalins.com/about/legal/index-enrollee.html.
Copyright © 2022 Delta Dental. All rights reserved.
EF60_DCU #133904.12 (rev. 03/22)
