Glossary of Terms
Annual Benefit Maximum
Your Annual Benefit Maximum is the amount that Delta Dental of Kansas will pay for covered dental services in one plan year, after you pay your deductible. Your Annual Benefit Maximum is $3,000 per person. This means a $3,000 Annual Maximum for each person in your family who is covered under this plan.
Basic Services
Delta Dental of Kansas categorizes dental services into three main categories: Diagnostic & Preventive Services, Basic Services, and Major Services. Each category varies in the complexity of dental services. Basic services include services like emergency examinations, oral surgery, root canals, and gum disease treatment. With your plan, Basic services (that are considered “covered services” under your plan) are covered at 100% after you pay your deductible and until you hit your Annual Benefit Maximum.
Benefit Booklet
A Benefit Booklet contains plan information including information that you won’t find on your Summary of Dental Benefits. Your Benefit Booklet can be accessed through your online member account. Your Benefit Booklet will contain detailed coverage and plan information.
Benefit Year (or Plan Year)
A Benefit Year, or Plan Year, is the year in which your plan is active. Your Benefit Year starts on the first day you are eligible for dental coverage. For example, if you applied for this plan, and your plan began on October 1, 2018, then your Benefit Year would be October 1, 2018 through September 30, 2019. You are covered for one Benefit Year to be eligible; to be eligible for a second year of coverage, you will need to re-apply.
Covered Services
Covered Services are dental services performed by an in-network dentist that are benefited by Delta Dental of Kansas. They are services that are eligible for your plan to pay for from your Annual Benefit Maximum.
Deductible
A Deductible is the amount you pay on your plan before Delta Dental of Kansas starts making payments for covered services. With your plan, your deductible is $5 per person and is not to exceed $10. This means if you have a family of two or more, your deductible will only be $10 for the plan year.
Delta Dental PPOTM
The Delta Dental PPO network is one of Delta Dental’s nationwide dentist networks. Over 65% of dentists in Kansas participate in this network.
Delta Dental Premier®
The Delta Dental Premier network is one of Delta Dental’s nationwide dentist networks. Over 95% of dentists in Kansas participate in this network.
Diagnostic & Preventive Services
Delta Dental of Kansas categorizes dental services into three main categories: Diagnostic & Preventive Services, Basic Service and Major Services. Each category varies in the complexity of dental services. Diagnostic & Preventive services include services like teeth cleanings, X-rays, Sealants and Fluoride treatment. With your plan, Diagnostic & Preventive services (that are considered “covered services” under your plan) are covered at 100% after you pay your deductible and until you hit your Annual Benefit Maximum.
Major Services
Delta Dental of Kansas categorizes dental services into three main categories: Diagnostic & Preventive Services, Basic Services and Major Services. Each category varies in the complexity of dental services. Major services include services like dentures and special restorative services. With your plan, Major services (that are considered “covered services” under your plan) are covered at 100% after you pay your deductible and until you hit your Annual Benefit Maximum.
Network (In-Network, Out-of-Network)
A network in dental insurance is a group of dentists who participate with an insurance carrier. With Delta Dental, we have two networks: Delta Dental PPOTM and Delta Dental Premier®. With your plan, dentists in these two networks are considered “in-network”. Dentists that do not participate in either of these two plans are considered “out-of-network”. With your plan, you MUST see an “in-network” dentist in order to receive your plan benefits. You can easily find an in-network dentist by using Delta Dental’s dentist search.
Primary Subscriber
The Primary Subscriber in your dental plan is the individual who filled out the initial application. The Primary Subscriber will be the name printed on all copies of your ID cards, but can be used by any member of your family.
Member Account
You can access your member account by clicking here. If you have never logged in to your member account before, you will need to register a username and password to gain access to the secure portal by clicking on “Need to register?”. Through your member account, you can: print your ID card to use at your dentist appointments, access your benefit booklet to learn more about your coverage, view your benefits and eligibility, view your claims and explanation of benefits and more.
Summary of Dental Benefits
A Summary of Dental Benefits summarizes your benefit and coverage information on one sheet. You can access your Summary of Dental Benefits by clicking here.
Waiting Period
A Waiting Period is a period of time that an individual must be covered under the dental plan before they are eligible for coverage of certain services. With your plan, there are no waiting periods.