How will I be reimbursed?
When you visit a dentist that participates in the Delta Dental network covered by your plan, your claims will be filed for you. You may be responsible for any coinsurance and/or deductible due to the dentist on the day of your appointment. If you choose to visit an out-of-network dentist, you may be responsible for all payments and charges to the dentist at the time of treatment. You may also be responsible for submitting the claim form to Delta Dental of Kansas in most cases, Delta Dental will send you reimbursement for the covered services. You can access a claim form by logging in to your Member Account.
How can I check the status of my claim?
You can check your claims history by logging into your member portal or by calling our Customer Service Team at 800-234-3375. Because of the large volume of claims received each day, please allow 10 - 14 business days for processing before contacting Customer Service Team to confirm receipt of your claim.
Can I add family members to my dental coverage at any time?
Dependent family members can only be added during open enrollment periods through your employer or when a qualifying event occurs.
I have a fully disabled dependent; how long is he/she covered under my policy?
As long as the individual remains disabled and is fully dependent on you for support and is unmarried, he or she can remain a dependent on your insurance policy. Written proof is required from the attending physician to verify the dependent’s disability.
What do I need to send to Delta Dental to verify my child’s full-time student status?
Please provide Delta Dental with a copy of a document that proves the student is enrolled at a secondary institution and is taking at least 12 credit hours. Acceptable documentation includes a copy of a paid tuition bill or a letter from the registrar.
Why was my child taken off my dental policy?
Under some group dental plans, dependents over age 19 are not eligible for dental coverage unless they are full-time students, earning at least 12 credit hours per semester. If your child is eligible for student coverage, please notify your group so your child can be reinstated on your policy.
My child has braces and we just switched to Delta Dental. Are our orthodontic payments covered under our Delta Dental insurance?
Depending on your group contract regarding orthodontic takeover coverage, Delta Dental may or may not assume coverage of orthodontic benefits. To determine if your plan includes coverage for orthodontic services that are in progress, check your Benefit Booklet or contact our Customer Service team.
I had individual X-rays taken and Delta Dental paid for a full mouth X-ray. Why?
It is Delta Dental’s policy that the fee for individual (periapical) X-rays cannot be higher than the fee for a full-mouth X-ray series. If this occurs, Delta Dental will pay the amount for a full-mouth X-ray series.
Why was my exam not covered when my dentist referred me to a specialist?
According to your group contract, examinations are covered benefits that may be subject to frequency limitations. This is true whether the examination is performed by a general dentist or by a specialist. To review your frequency limitations, log in to your member account to view your Benefit Booklet.
Why did Delta Dental pay for a silver (amalgam) filling my my back tooth when my dentist filled the tooth with a white (composite) filling?
Your plan may only cover the cost of a silver (amalgam) filling in a posterior (back) tooth. If you and your dentist decide to restore the tooth with a white (composite resin) filling, Delta Dental will pay for the cost of the silver (amalgam) filling, and you will be responsible for the remaining cost (the difference in cost between the silver and white fillings).
Why does Delta Dental reimburse orthodontic payments monthly instead of paying the entire amount upfront?
Delta Dental’s policy is to pay for completed services, so once the monthly visit is completed, a payment will follow. Orthodontic payments from Delta Dental are distributed throughout the period of time the services are received.
I had a tooth surgically pulled (extracted) and the insurance claim was filed with my medical insurance. Why doesn’t my dental insurance cover the claim?
Depending on your group coverage, claims for surgical extraction of wisdom teeth may need to first be submitted to your medical insurance carrier and then to your dental insurance. Some medical plans pay up to 100% of this procedure, so filing this type of extraction with your medical insurance could be of benefit to you. If there are any remaining charges after the medical insurance carrier has paid, your dental plan may cover the remainder or a portion of the remaining balance. Contact our Customer Service team for specific details regarding your plan.
How do I find details on my dental coverage?
You can log in to your member account to view your Benefit Booklet. You can also request a printed copy be sent to you by contacting our Customer Service team.
When does coverage begin after a qualifying event occurs?
Coverage begins the first of the month following the date of the qualifying event. Delta Dental must receive notice of the change in eligibility status within 31 days of the qualifying event, otherwise the change may only be made at the renewal date of the group contract if the employer allows an open enrollment.
Can I join the plan during the Plan Year?
Coverage can be elected at your employer’s renewal date if your employer allows an open enrollment period or if a qualifying event occurs. We need to be notified within 31 days of the qualifying event.
A qualifying event includes:
- Birth / legal custody / adoption
- Death
- Loss of other dental insurance coverage
- Marriage/divorce
Can I add a family member to my dental coverage at any time?
No, dependent family members can only be added at the renewal date of the group contract if the employer allows open enrollment periods or when a qualifying event occurs. We need to be notified within 31 days of the qualifying event.
A qualifying event includes:
- Birth / legal custody / adoption
- Death
- Loss of other dental insurance coverage
- Marriage/divorce
How do I check to see if I am eligible for coverage?
It’s easy to check your current eligibility status and view a summary of your plan’s dental benefits by logging into your member account. You can also contact our Customer Service team.
Do I need a referral to see a specialist?
If you’re a member of Delta Dental, you do not need a referral to receive care from a specialist. However, we strongly encourage you to use the services of a Delta Dental participating specialist to maximize your benefit coverage. Find an in-network specialist.
I’m covered under two dental plans. How is my coverage handled?
Delta Dental will coordinate benefit with other dental plans. One of your dental plans will be considered “primary”, meaning that dental plan would receive the claim first for payment, and then the claim would go to your second, or “secondary” dental plan. Generally, if you are covered as an employee and also as a dependent of an employee at another company, the coverage through your employer is “primary”. Children covered by parents who work for different employers are usually “primary” under the plan of the parent whose birthday occurs first in the calendar year (not necessarily the oldest parent).
In determining coverage, total payments from both dental plans cannot exceed 100% of the approved fee for the service. Please note, that some groups have specified a “carve-out” clause in their dental programs that might limit a secondary carrier’s payment. If you have a question about the Coordination of Benefits between two plans, please contact our Customer Service team.
When am I eligible for dental coverage? Does Delta Dental have waiting periods for services?
Some employer group and individual plans have various waiting periods. You can log in to your member account to check your Benefit Booklet to see if your plan has waiting periods for certain services.
I’m losing coverage through my employer soon, does Delta Dental offer individual and family dental plans?
Yes! Learn more about our individual and family plans by clicking here.
Does my group coverage run on a calendar year or a contract year?
The anniversary date for coverage varies from group to group. For specific information on your benefits or benefit year, log in to your member account. You can also contact our Customer Service team.
What are predeterminations and are they mandatory?
A predetermination of benefits (or pre-treatment estimate) allows you to know in advance what procedures are covered, the amount your plan will pay toward treatment and your financial responsibility. Predeterminations are submitted by your dentist.
Some groups and some conditions require a predetermination of benefits before treatment is performed in order for your treatment to be covered by your benefits. Treatment plans that involve prosthodontic services, orthodontic services, individual crowns (except stainless steel), gold restorations, surgical periodontics, endodontics and oral surgery (except for simple extraction of a single tooth) should be submitted to Delta Dental for a predetermination of benefits. Please refer to your Benefit Booklet to see the exact services for which predeterminations are required. Even if it is not required, Delta Dental encourages predeterminations for extensive treatments or if you visit an out-of-network dentist. If submitted by an in-network dentist, there is no charge for a predetermination, and it is valid for 6 months.
I just received something in the mail from Delta Dental that looks like a bill. What is it?
You probably received an Explanation of Benefits (EOB) statement. This statement is not a bill; it explains what services your dentist provided and how Delta Dental processed and paid for the services.
You can sign up to receive these by email instead of mail through your member account.
May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?
This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon.
If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.
If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.
I have an upcoming dentist appointment. How do I know how much it’s going to cost?
Use Delta Dental’s Dental Care Cost Estimator to estimate your out-of-pocket costs before you go. You can use the Dental Care Cost Estimator by logging in to Delta Dental’s mobile app.
How do I register for a Delta Dental of Kansas member account?
It’s simple! Under the member account login, click “Register”. You will enter your name, member ID, date of birth and ZIP code. You’ll create your username and password that you’ll use on both the online member account and on the Delta Dental mobile app.
Do I need a referral to see a specialist?
If you’re a member of Delta Dental, you do not need a referral to receive care from a specialist. However, we strongly encourage you to use the services of a Delta Dental participating specialist to maximize your benefit coverage. Find an in-network specialist.
When am I eligible for dental coverage? Does Delta Dental have waiting periods for services?
Some employer group and individual plans have various waiting periods. You can log in to your member account to check your Benefit Booklet to see if your plan has waiting periods for certain services.
Does my group coverage run on a calendar year or a contract year?
The anniversary date for coverage varies from group to group. For specific information on your benefits or benefit year, log in to your member account. You can also contact our Customer Service team.
What are predeterminations and are they mandatory?
A predetermination of benefits (or pre-treatment estimate) allows you to know in advance what procedures are covered, the amount your plan will pay toward treatment and your financial responsibility. Predeterminations are submitted by your dentist.
Some groups and some conditions require a predetermination of benefits before treatment is performed in order for your treatment to be covered by your benefits. Treatment plans that involve prosthodontic services, orthodontic services, individual crowns (except stainless steel), gold restorations, surgical periodontics, endodontics and oral surgery (except for simple extraction of a single tooth) should be submitted to Delta Dental for a predetermination of benefits. Please refer to your Benefit Booklet to see the exact services for which predeterminations are required. Even if it is not required, Delta Dental encourages predeterminations for extensive treatments or if you visit an out-of-network dentist. If submitted by an in-network dentist, there is no charge for a predetermination, and it is valid for 6 months.
What is Delta Dental of Kansas’ mailing address?
Claims mailing address:
Delta Dental of Kansas
P.O. Box 70201
London, KY 40742
General mailing address:
Delta Dental of Kansas
P.O. Box 789769
Wichita, KS 67278-9769
My dentist isn’t in the Delta Dental network. How does Delta Dental pay for my benefits?
Please note that if you visit an out-of-network dentist, you may be required to submit a claim form for the services rendered and possibly pay for them upfront — and then wait for reimbursement from Delta Dental.
When you visit an out-of-network dentist, any payment made by Delta Dental will be made directly to you. Download the dental claim form and submit to Delta Dental of Kansas by email, mail or fax.
You can nominate your dentist to participate in Delta Dental’s networks by filling out this form.
Download the claim form by logging in to your member account.
May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?
This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon.
If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.
If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.
How do I access my Benefit Booklet?
You can access your Benefit Booklet on your member account. If you don’t have a member account, you will need to register for one here.
You can also request a printed copy be sent to you by contacting our Customer Service team.
How do I access my ID card?
You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.
If you would like us to send you additional ID cards, contact our Customer Service team.
Do I need my ID card for my dentist appointment?
No, your dental office will be able to look you up by your social security number or member identification number if you don’t have your ID card with you. They may also call our office to verify coverage.
You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.
If you would like us to send you additional ID cards, contact our Customer Service team.
Where can I find my dentists information?
You can save your favorite dentists using the Delta Dental Mobile App for quick access to contact information making it easy to schedule your routine cleaning.
How can I view my past claims?
You can use the Delta Dental of Kansas Mobile App to look up detailed claims information for your dentist visits over the last 18 months.
I have an upcoming dentist appointment. How do I know how much it’s going to cost?
Use Delta Dental’s Dental Care Cost Estimator to estimate your out-of-pocket costs before you go. You can use the Dental Care Cost Estimator by logging in to Delta Dental’s mobile app.
How do I register for a Delta Dental of Kansas member account?
It’s simple! Under the member account login, click “Register”. You will enter your name, member ID, date of birth and ZIP code. You’ll create your username and password that you’ll use on both the online member account and on the Delta Dental mobile app.
How do I use the Dental Care Cost Estimator on the Delta Dental mobile app?
After logging in to the mobile app, tap on the Cost Estimator icon at the bottom center of your screen. Select who the estimate is for, your ZIP code, the treatment you would like to look up and your dentist. To find your dentist, start by typing their last name in the search box and then tap the search button to the right and select your dentist.
Tap on “Get Cost Estimate”. You will see a screen that will show your estimated out-of-pocket costs based on your plan details. You will see if your deductible is applied and how much of your maximum would be remaining.
The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures.
Learn more about Delta Dental’s mobile app.
I found a problem in the app. How do I report it?
Please report any bugs or glitches in the mobile app to support@deltadental.com.
I tried to log in to the mobile app, but my account is locked. How do I unlock my account?
For security reasons, your account is locked after a certain amount of failed attempts to log in. To unlock your account, contact our Customer Service team.
To prevent your account from being locked in the future, use the “Forgot Username” and “Forgot Password" links on the login screen.
How do I log in to the mobile app?
You use the same username and password you use to log in to your Delta Dental of Kansas member account. If you haven’t registered for a member account yet, you can register online or through the mobile app.
May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?
This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon.
If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.
If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.
How do I access my Benefit Booklet?
You can access your Benefit Booklet on your member account. If you don’t have a member account, you will need to register for one here.
You can also request a printed copy be sent to you by contacting our Customer Service team.
How do I access my ID card?
You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.
If you would like us to send you additional ID cards, contact our Customer Service team.
Do I need my ID card for my dentist appointment?
No, your dental office will be able to look you up by your social security number or member identification number if you don’t have your ID card with you. They may also call our office to verify coverage.
You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.
If you would like us to send you additional ID cards, contact our Customer Service team.
How do I register for a Delta Dental of Kansas member account?
It’s simple! Under the member account login, click “Register”. You will enter your name, member ID, date of birth and ZIP code. You’ll create your username and password that you’ll use on both the online member account and on the Delta Dental mobile app.
I tried to log in to my member account, but my account is locked. How do I unlock my account?
Simply contact us and we will unlock your account.
How do I sign up to receive Explanation of Benefits (EOBs) by email instead of mail?
It’s easy! Log in to your member account. Click on “Explanation of Benefits”, then click on “Go Green — Explanation of Benefits Online”. From there, you can edit your Subscriber Profile so that you receive explanation of benefit notifications via email for you to view online.
How do I find details on my dental coverage?
You can log in to your member account to view your Benefit Booklet. You can also request a printed copy be sent to you by contacting our Customer Service team.
How do I check to see if I am eligible for coverage?
It’s easy to check your current eligibility status and view a summary of your plan’s dental benefits by logging into your member account. You can also contact our Customer Service team.
When am I eligible for dental coverage? Does Delta Dental have waiting periods for services?
Some employer group and individual plans have various waiting periods. You can log in to your member account to check your Benefit Booklet to see if your plan has waiting periods for certain services.
Does my group coverage run on a calendar year or a contract year?
The anniversary date for coverage varies from group to group. For specific information on your benefits or benefit year, log in to your member account. You can also contact our Customer Service team.
May I visit any dentist I wish for treatment? What if my dentist doesn’t participate with Delta Dental?
This depends on your plan type. You can find your plan type in your Benefit Booklet on your member account or by logging in to the mobile app and tapping on the “My Coverage” icon.
If you have a PPO-only (or EPO — exclusive provider option) plan, you will only receive benefits when you visit a Delta Dental PPOTM Network dentist. You can search for PPO dentists here. Make sure to choose Delta Dental PPO as your network.
If you don’t have a PPO-only plan, then you are free to visit any dentist (in or out-of-network); however, you may have more out-of-pocket expenses if you visit an out-of-network dentist. Depending on your benefits plan, your coverage may involve a larger deductible and/or different co-insurance percentage if you go to a dentist who doesn’t participate with your specific plan. Locate a participating dentist in our Delta Dental Premier or Delta Dental PPO networks or contact our Customer Service team.
How do I access my Benefit Booklet?
You can access your Benefit Booklet on your member account. If you don’t have a member account, you will need to register for one here.
You can also request a printed copy be sent to you by contacting our Customer Service team.
How do I access my ID card?
You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.
If you would like us to send you additional ID cards, contact our Customer Service team.
Do I need my ID card for my dentist appointment?
No, your dental office will be able to look you up by your social security number or member identification number if you don’t have your ID card with you. They may also call our office to verify coverage.
You can print ID cards from your member account or you can use your mobile ID card by downloading the Delta Dental mobile app. If you don’t have a member account, you will need to register for one here.
If you would like us to send you additional ID cards, contact our Customer Service team.
How do I terminate my COBRA coverage?
If you wish to terminate your COBRA coverage, for which Delta Dental is the billing authority, please send written notification to our Eligibility team at P.O. Box 789769, Wichita, KS 67278-9769. Please include your name, date of birth, ID number, the requested termination date and contact information. If your former employer or a third-party administrator is the billing authority for your COBRA coverage, you will need to contact them directly.
I have not received a bill for my COBRA coverage. What do I do?
COBRA billing authority varies by employer. Your COBRA premium may be collected by Delta Dental, your former employer or by a third-party administrator hired by your former employer. Contact your former employer to inquire about payment procedures for your group.
Federal law does not require us to provide a monthly billing statement. If Delta Dental is responsible for collecting your payment, we may issue COBRA coupons to attach to your monthly payment, but it is the responsibility of the COBRA participant to make sure that their payment reaches the billing authority by the last day of the month for which the premium is due. If payment is not received by the last day of the month for which the premium is due, COBRA coverage will be terminated and cannot be reinstated. For example, my premium for October coverage is due on October 1. Coverage will terminate if payment is not received by October 31.
When does my COBRA coverage start?
Normally, COBRA coverage begins the day following your last day of coverage under the active employee plan. However, please check with your former employer for specific information regarding your individual situation.
Are all employers required to offer COBRA coverage?
Not all employees are obligated to offer COBRA coverage. Please check with your former employer for information on COBRA coverage. COBRA enrollment periods may vary, so please ask about enrollment deadlines and length of coverage as well.
How do I apply for COBRA coverage?
You should contact your former employer regarding eligibility for COBRA coverage and to request an application for continuation of group dental coverage.
