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Dental Plan For Employees And Dependents

How To Use The Dental Care Plan

The patient may be treated by any licensed dentist. In the event the patient does not have a personal dentist, he/she may refer to the listing of Delta Dental Plan Participating Dentists. This listing is updated periodically by Delta.

During the first appointment the patient should inform the dentist that he/she is covered by the Denver Public Schools Delta Group No. 1015 and give the dentist the group name, group number, and the social security number of the employee covered. It is important that the dentist be told that Delta is providing the coverage, as most dentists will be familiar with the Delta dental care program and will have the necessary treatment forms in their office. The dentist should be asked to contact Delta if he/she does not have the treatment forms or desires additional information regarding the plan.

The dentist may examine, clean and x-ray the teeth, provide emergency treatment and render minor dental procedures without obtaining prior approval by Delta. The dentist will complete a treatment f  + +Xm..  + +QmFINDER DAT" + +Ym( appea-ls.htmlPPEAL~1HTM p|+\$nESOURCEFRK + +\mtmluarbitration.hRBITR~1HTM q|+\$~htmlstbeneftitchart.ENEFI~1HTM q|+\$4&tmlbenefitinfo.hENEFI~2HTM q|+\$qbenef4its.htmlENEFI~3HTM r|+\$%Pcob.hctmlOB~1 HTM r|+\$htmlcontianuation.ONTIN~1HTM s|+\$.!s.htm3lcoveri3agestartOVERA~1HTM s|+\$}.htmlcovernagestopsOVERA~2HTM s|+\$tmlTdefinitions.hEFINI~1HTM t|+\$eligiIble.htmlLIGIB~1HTM t|+\$lwemergGwency.htmMERGE~1HTM t|+\$^,lMfinanMcial.htmINANC~1HTM t|+\$7ions.htmlgenerealprovisENERA~1HTM u|+\$-lkhospitktals.htmOSPIT~1HTM u|+\$ howplan.htmlOWPLA~1HTM u|+\$>howtouse.htmlOWTOU~1HTM u|+\$mimageoqsMAGES y|++indexI3.htmlNDEX~1 HTM v|+\$.medicare.htmlEDICA~1HTM v|+\$mlnotcovered.htOTCOV~1HTM v|+\$Ahtmlphonenumbers.HONEN~1HTM w|+\$)lXreferrals.htmEFERR~1HTM w|+\$appeals.htmlyR<xpy.TEXTMOSSuDDPPEAL~1HTMparbitration.html<xpyTEXTMOSSuFDRBITR~1HTMpbenefitchart.html<xpy TEXTMOSSuFDENEFI~1HTMpbenefitinfo.html y TEXTMOSS@uFDENEFI~2HTMpbenefits.htmly TEXTdosa@uHDENEFI~3HTMpcob.htmlsJ yxpy TEXTdosa@uHDOB~1 HTMpcontinuation.htmlxpy TEXTdosauJDONTIN~1HTMpcoveragestarts.htmlpy TEXTdosauJD~OVERA~1HTMpcoveragestops.htmlxpy TEXTdosauJD}OVERA~2HTMpdefinitions.htmlxp y TEXTdosauLD|EFINI~1HTMpeligible.htmlxpy TEXTdosauLD{LIGIB~1HTMpemergency.htmlxpy TEXTdosauLDzMERGE~1HTMpfinancial.htmlxpy TEXTdosauLDyINANC~1HTMpgeneralprovisions.htmly TEXTdosauNDxENERA~1HTMphospitals.htmlxp y TEXTdosauNDwOSPIT~1HTMphowplan.htmlyxp y TEXTdosa@uNDvOWPLA~1HTMphowtouse.htmlxpy TEXTdosa@uNDuOWTOU~1HTMpimagessJ Vxpy @uV^tMAGES pindex.html yxpyTEXTdosa@uPDrNDEX~1 HTMpmedicare.htmlxpy TEXTdosauPDqEDICA~1HTMpnotcovered.htmlxpy TEXTMOSSuPDpOTCOV~1HTMpphonenumbers.htmlxp y TEXTMOSSuRDoHONEN~1HTMpatesEvent Schedulebove two criteria and is justifiable considering the special circumstances of the particular case involved.

Benefit Percentages

CO-PAYMENT - Diagnostic and Preventive Delta will pay 100% of a Participating Dentist's usual, customary and reasonable fee.

CO-PAYMENT - Restorative Delta will pay 80% of a Participating Dentist's usual, customary and reasonable fee.

CO-PAYMENT - Major Services Delta will pay 50% of a Participating Dentist's usual, customary and reasonable fee for Oral Surgery, Endodontics, Periodontics, Cast Restorations and Prosthodontics. Benefits payable under this part of the Plan are subject to a $50 lifetime deductible, per eligible individual.

CO-PAYMENT - Orthodontic Services Delta will pay 50% of a Participating Dentist's usual, customary and reasonable fee.

Maximum Benefit

The benefits payable under the Plan will not exceed $1,000 per eligible individual during any one calendar year.
The benefits payable for Orthodontic Services are $1,000 per eligible individual during a lifetime.

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Introduction | Welcome | Covered Services | Exclusions

Website for Delta Dental

Denver Public Schools
Employee Benefits Department
900 Grant Street, Room 502
Denver, Colorado 80203
(303) 764-3371