3-minute read

If you’re taking a consultative approach to selling benefits, you most likely aim to help your clients answer their enrollees’ biting benefits questions. Especially if you work with small business owners, it’s important to brush up on plan details so you’re ready to provide support when necessary.

Health insurance, both medical and dental, can be confusing. Even if enrollees understand plan basics, the details can be tough to understand – and difficult to find. So we’re going to break down three common myths about choosing a dentist, for both Delta Dental PPOTM and DeltaCare® USA plans.

MYTH: Enrollees don’t have much choice, if any, in the dentist they visit.

FACT: Not true. In a PPO plan, enrollees and their dependents can visit any licensed dentist and use their plan benefits. (However, they will usually save more when they visit a Delta Dental PPO dentist.)

For DeltaCare USA enrollees, this is a myth as well. Though our copay plans feature a narrower network of dentists to choose from, enrollees have the option to select a dentist from the DeltaCare USA network. If they don’t make a selection, then we will assign them a network dentist near their home address. Enrollees can also change their selected network dentist, and changes will be effective the following month.

With Delta Dental PPO and DeltaCare USA, enrollees may have more freedom to choose their dentist than you think.

MYTH: Enrollees must present an ID card when they visit the dentist.

FACT: Regardless of plan type, this is not a requirement. Enrollees can simply provide the dentist with their name, date of birth and social security number or enrollee ID to verify coverage. Or they can display ID cards from their mobile device by logging in to Online Services on deltadentalins.com.

We could all benefit from going green, so encourage enrollees to take their ID cards on the go.

MYTH: Enrollees need to submit claim forms for each dentist visit.

FACT: Convenience is a major advantage of visiting a network dentist. For our PPO and copay plans, enrollees do not need to file claims when they visit a dentist in their network for routine dental care. Enrollees simply visit their dentist, pay their set copayment or share of coinsurance and leave with a healthier smile.

Claim forms may apply for out-of-network, specialty and emergency care, or to get a pre-treatment estimate.

For a quick guide to answering enrollees’ benefit questions, direct your clients to our resources for benefits administrators online.

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