Frequently asked questions

How do I make payments for my dental plan?

When processing an application, the very first month of premium payment is due at the time of enrollment. Future payments will be deducted on the 27^th of each month which pays for the next month of coverage. (Example: September 27^th billing date pays for October coverage.)

We accept Electronic Funds Transfer (EFT) from a checking or savings account. We also accept debit or credit cards from Visa, Discover, or Mastercard. Currently, we do not accept American Express.

If you need to manually make a past due payment or would like to make an advanced payment, you can do so in the following ways:

• Process a one-time payment on our website without logging in
• Log in to your member account to make a payment using your existing payment method
• Use our automated phone system to process a payment over the phone
• Contact our customer service team to make a payment with an agent

Can I change my billing date?

We are unable to change the automatic billing date, but you do have the ability to pay your monthly premium ahead of time to suit your financial schedule. We also offer semi-annual or annual billing frequencies.

How do I choose a different billing frequency?

You can choose your billing frequency at enrollment. To change your billing frequency after enrollment, call our contact center at 1-888-899-3734.

How do I update my payment method?

You have the option to update your payment method by signing into your online account, using our automated phone system, or by speaking with a customer service representative at 1-888-899-3734.

What happens if I miss a monthly payment?

If your premium payment was missed, you will have a one-month grace period to make up that payment. If no payments are received by the end of your one-month grace period, the policy will terminate due to non-payment and may be subject to a 12-month lockout.

To address concerns on a specific billing situation, contact our customer service team at 1-888-899-3734.

How can I see all my previous payments and invoices for my dental plan?

Sign in to your online account and choose “Billing history,” from the “Billing & Payments” menu. Your ten most recent payments will be displayed.

• Increase the number of payments shown by using the dropdown box above the Billing Period column.
• Use the Search box to filter by a specific time period. For example, searching for 2023 will show all bills generated and payments made in that year.
• Print or save the information as a PDF by clicking the green Print icon at the top of the page.

What is a predetermination?

A predetermination is also known as a pretreatment estimate. This is used to verify coverage of a treatment, as well as receive an estimate of your out-of-pocket cost.

Predeterminations are recommended for more extensive procedures such as crowns, wisdom tooth extractions, bridges, periodontal surgery, dental implants, and dentures.

How do I get a predetermination before my services?

Make the request to your dentist, who will then send a proposed treatment plan (including relevant X-rays) to Delta Dental. We verify which services are covered under your dental plan and estimate out-of-pocket costs.

A predetermination, valid for 180 days, will be mailed to you and your dentist qualifying the services covered by your policy and estimate out-of-pocket costs. This document is also posted to your online account.

Should I get an estimate before having a dental treatment done?

Yes, we do recommend requesting a pretreatment estimate from your dentist, especially for more extensive treatments such as crowns, wisdom tooth extractions, bridges, periodontal surgery, dental implants, and dentures.

Many of our dental policies require a 12-month commitment. We recommend reviewing your policy contract for state- and policy-specific guidelines on the requirements and instructions for termination.

Email: Use the email us form on the Contact Us page
Fax: 1-800-807-1970
Mailing Address: P.O. Box 103, Stevens Point, WI 54406

Within your request, be sure to include your first and last name, date of birth, full address, policy number, reason for cancellation, and requested termination date.

How do I make changes to my policy?

Most states require any policy changes to be submitted in writing, but some states allow verbal policy changes. We recommend reviewing your policy contract for policy and state-specific requirements on making changes.

If you have additional questions after reviewing your policy contract, or need help finding your policy contract, contact our customer service team at 1-888-899-3734.

I’ve already enrolled in a policy, do I need to register on the website?

Registering on the website is not required but it allows you access to your claims history, billing information, and gives you the ability to update your contact information.

How do I sign up for an online account?

After enrolling in benefits either on our website or over the phone, we recommend waiting 48 hours to allow our systems to fully update with your information.

You can register for your online account here.

To create an account, click the “Sign in or Register” button at the top of the page and then “Register now.” You will need to enter your first and last name, date of birth, email address and the subscriber’s member id number. If you don’t know the subscriber’s member id number, you can register using your name, date of birth, and address. If you’re having any trouble registering, please call our customer service team at 1-888-899-3734.

How do I change my password and/or security question?

To change your password and/or security question, sign in with your username and current password, then under “My account” choose “Password & security.” From there you will be able to change your password and update your security question.

I forgot my username and/or password. How can I sign in?

To retrieve your username and/or reset your password, click "Sign in" button then "Forgot user name or password." Follow the three-step process. For username, you will also need to enter the email address on file.

How do I change my email preferences, including the email address I provided upon initial registration?

To change your email preferences, sign in with your username and password, then under “My account” choose “Email & communications.” From there you will be able to update your email address, paperless options, and change email preferences.

How do I chat with a customer service representative?

Log in to your online account to securely chat in real time with a real person who can assist with billing benefits, claims, eligibility, or any other service needs. Just click on the purple chat icon in the lower right corner when on the member dashboard.

Can I choose my own dentist?

Yes, there are different networks depending on which Delta Dental plan you have selected. To maximize the use of your benefits, find an in-network dentist using our find a provider tool. Enter the criteria important to you, select your plan, and click "Search."

Will my dental plan provide coverage when I’m outside of my home state?

Delta Dental covers you nationwide. Even if you’re out of state on business or traveling with family, you can find an in-network dentist using our find a provider tool.

Do I have to see a primary care dentist to get a referral to a specialist?

For most Delta Dental plans, you may go to any in-network dentist for your plan.

What does non-duplication of benefits mean?

When you're covered by two dental policies, the non-duplication of benefits provision describes how a secondary policy may calculate its portion of payment. The secondary policy pays as much as it would pay if it were primary, minus the primary payment amount.

For example, if the primary policy paid 80 percent and the secondary policy would cover 80 percent if it was primary, the secondary policy would not make an additional payment.

If the primary policy paid 50 percent and the secondary policy would cover 80 percent, the secondary policy would pay up to 30 percent. 

How many teeth cleanings do my benefits cover per year?

This is dependent on the type of dental plan that you purchased. Check your dental coverage by signing into your account. Note that your benefits refer to a teeth cleaning as Prophylaxis.

Are sealants covered on restored molars?

Sealants are covered on permanent molars with no restorations or decay on the chewing surface.

How do I add a dependent to my policy?

Email: Use the email us form on the Contact Us page
Fax: 1-800-807-1970
Mailing Address: P.O. Box 103, Stevens Point, WI 54406

Within your request, be sure to include your first and last name, date of birth, full address, policy number, and dependent information including first and last name, date of birth, full address, requested effective date, and reason for adding (newborn or adoption).

When should I take my child to the dentist for their first checkup?

We recommend taking your child to their first dental visit by their first birthday. This helps your child to develop good habits for protecting their smile as they grow.

Can my child use the plan while at college?

Yes, Delta Dental network member dentists are available nationwide. You can access a list of dentists located near your child’s college using our find a provider tool.

What form do I need to view over-age dependents information or if I am having custody issues?

Use the HIPAA Authorization form found in the download forms section. 

I did not get an ID card. How will my dentist know I have coverage through Delta Dental?

An ID card is not necessary to receive services. The dental office can use your name and member ID to verify eligibility and submit claims.

To obtain a copy of your ID card, sign into your online account to print, email, or save your ID card. If you do not have access to a printer, please submit a request using the email us form on the Contact Us page to have an ID card mailed to you.

Why is there only one ID card available in my online account?

The ID card available in your online account only lists the primary subscriber on the card, but can be used for all individuals included on the benefit plan.

What is my member ID number?

Your member ID number is a unique number that identifies you as a Delta Dental subscriber under your dental plan. It may be your Social Security Number or a randomly selected identification number that has been assigned.

Do I need to submit a claim after receiving treatment or will my dentist handle it?

If you receive treatment from a Delta Dental network dentist, they will file all claim information for you. If you visit an out-of-network dentist, you may be responsible for submitting claim information.

How do I get a claim form

You can download a standard claim form found in the download forms section. You can also get an American Dental Association-approved claim form from your dentist.

What is the mailing address for Delta Dental claims?

Delta Dental network dentists will submit your claims for you. In the case you visit an out-of-network provider, please send your claims to:

Delta Dental
P.O. Box 103
Stevens Point, WI 54481-0103

How will I know when my claim is processed?

When a claim is processed you will receive a notification via email or postal mail, depending on the communication preferences set in your account.

You can view recently-processed claim information by signing in to your online account and navigating to Claims. Please note: pending claims that have not finished processing will not appear in your online account. If you would like to check on the status of a pending claim, please call our contact center at 1-888-899-3734.

To change your communication preferences, sign in to your online account and under “My account” choose “Communication preferences”.

What should I do if a claim has not been received?

If you or the dental office had difficulty submitting claims, please verify the correct member ID number and claims submission information found on your ID card is being used. If additional assistance is needed, please call our contact center at 1-888-899-3734.

To obtain a copy of your ID card, sign into your online account to print, email, or save your ID card. If you do not have access to a printer, please submit a request using the email us form on the Contact Us page to have an ID card mailed to you.

Please note: claims that are pending and have not yet finished processing will not appear in your online account. If you would like to check on the status of a pending claim, please call our contact center at 1-888-899-3734.

How do I submit a claims appeal or grievance?

To submit an appeal or grievance, you will generally need to send a written request to the following address:

Delta Dental
P.O. box 103
Stevens Point, WI 54481-0103

Please include all relevant details and documentation to support your case.

If you are in the state of Washington, you have the option to submit an appeal or grievance verbally; please contact our customer service team to do so.

Most states allow 180 days from the date of the initial decision to submit an appeal or grievance, but please check your specific state regulations as some states may offer a longer period. For more detailed instructions or to confirm your state's specific requirements, please review your policy document, which can be found in the Documents section of your online Member Portal account.

What is a Delta Dental “network dentist?”

Delta Dental network dentists have signed an agreement to provide dental treatment to patients covered by Delta Dental's dental care programs at a reduced fee. Other benefits of seeing a member dentist are:

What is the difference between a Delta Dental Premier® and Delta Dental PPO™ dentist?

Delta Dental PPO™ is a broad network that provides the best value and lowest out-of-pocket cost.

The Dental Dental Premier® premier network offers additional dentists choose from, but with a slightly smaller discount.

Together they create the Delta Dental PPO Plus Premier™ network.