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)
Diagnostic and preventive procedures (like cleanings, exams, and X-rays) are typically are covered at the highest percentage (around 90–100% of the allowable dental charge).
This coverage gives patients a financial incentive to seek preventive care because it can prevent more extensive dental disease and the procedures needed to treat it.
Class II (usually called Basic)
This category includes basic procedures such as fillings, extractions, and periodontal (gum) treatment that are often reimbursed at a slightly lower percentage (usually between 70 and 80%).
Class III (usually called Major)
These are major services such as crowns and dentures. This is usually reimbursed at a lower percentage (around 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. The typical plan includes limitations and exclusions, meaning the plan doesn’t cover every aspect of dental care. This can relate to the type or number of procedures, the number or frequency of visits, or age limits.
If you want to find out more about your coverage specifics, log in to your subscriber account on our website at deltadentalco.com. There you will find your specific benefits and usage. Or contact a customer relations representative at 1-800-610-0201 or customer_service@ddpco.com
No matter what type of a dental benefit plan you have, it’s important to understand your plan offerings so you can use your benefits to help improve your health.
*Always make sure to check waiting periods before you buy any dental or medical plan.