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Dental Benefit Categories and Coverages

August 26, 2014 Delta Dental of Idaho

Many dental plans offer 3 classes or categories of coverage. Each class provides specific types of treatment and typically covers those treatments at a certain percentage.

Each class also specifies limitations and exclusions. Reimbursement levels vary from plan to plan, so be sure to read your benefits information carefully.

Here are the typical levels in benefit plans:

Class I (usually called Diagnostic & Preventive)

Procedures are diagnostic and preventive (e.g. examinations, cleanings, sealants, etc.) and typically are covered at the highest percentage (for example 90 – 100% of the allowable dental charge).

Gives patients a financial incentive to seek preventive care, because this care can prevent the development of dental disease.

Class II (usually called Basic)

Includes basic procedures — such as fillings, extractions and periodontal treatment — that are sometimes reimbursed at a slightly lower percentage (for example 70 – 80%).

Class III  (usually called Major)

For major services, such as crowns and dentures. This is usually reimbursed at a lower percentage (for example, 50%).

Class III may have a waiting period before services are covered.

Limitations and Exclusions

Dental plans are designed to help with part of your dental expenses. A typical plan includes limitations and exclusions, meaning the plan doesn’t cover every aspect of dental care. This can refer to the type or number of procedures, the number of visits or age limits.

To find out more about your coverage specifics, log on to our website at deltadentalid.com. There you will find your specific benefits and usage. Or, call us to talk with a Customer Service representative at 1 (800) 356-7586.

No matter what type of a dental benefit plan you have, it’s important to understand your plan offerings so that you can use your benefits to help improve your health.

Parenting Delta Dental, Delta Dental of Idaho, dental benefits, dental coverage, dental network, dental plans, dental procedures, oral health care, preventative care, visit the dentist

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Welcome to the Delta Dental of Idaho blog! Delta Dental of Idaho is the leading dental benefits carrier in the state, providing quality, affordable dental plans for both companies … read more

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