Frequently Asked Questions
Answers to your questions about Delta Dental of Illinois individual and family dental plans.
Answers to the most frequently asked questions about Delta Dental of Illinois individual and family plans are provided below. Simply click on a question to view the answer. Links throughout the answers will guide you to further information on our website. Should you have any further questions, please contact an Individual Plan Specialist at 877-824-2776, 8:30 a.m. to 5:00 p.m. or by email at email@example.com
- » Who is eligible to purchase a Delta Dental of Illinois individual and family plan?
- » Do I have coverage outside of Illinois?
- » What if I permanently move out of Illinois?
- » How do I enroll?
- » When will my dental policy be effective?
- » How can I cancel my policy?
- » How long are the rates guaranteed?
- » Are there services that are not covered?
- » What is the difference between Delta Dental PPO℠, DElta Dental Premier® and non-participating/out-of-network dentists?
- » Is treatment for a missing tooth immediately covered?
- » How can I find out if my dentist is part of the Delta Dental network?
- » What is the difference between the Gold, Silver and Bronze dental plan options?
- » Do I have to see a Delta Dental network dentist for dental care?
- » Where can I find my complete plan information?
- » Who should I contact with questions about my dental coverage?
Who is eligible to purchase a Delta Dental of Illinois individual and family plan?
Delta Dental of Illinois individual policies are available to all permanent residents of Illinois who do not have access to a group dental insurance plan. For eligible individuals, dental coverage is also available for your spouse/domestic partner and/or dependent children. (Children are eligible to age 26). Coverage types are: single, two-person, or family. The two-person policy can be for you and your spouse/domestic partner or dependent child.
Do I have dental coverage outside of Illinois?
Yes, your Delta Dental of Illinois coverage travels with you. Common examples are:
- » A secondary residence outside of Illinois.
- » Full-time students attending college in another state.
- » Traveling outside the state of Illinois, including international travel.
What if I permanently move out of Illinois?
Your coverage would terminate at the end of the month in which you changed residency. Plans are open to Illinois residents only, which means that you must reside in Illinois at least six months of the year.
How do I enroll?
The easiest way is to enroll online in just three easy steps. You may also download an application that you can print, complete and mail back to Delta Dental of Illinois. To request an application be mailed to you, call 877-824-2776, 8:30 a.m. to 5:00 p.m. central time, Monday through Friday or email firstname.lastname@example.org.
When will my dental policy be effective?
Your policy will be effective on the first day of the month following approval of your application. Please note, your application must be received by the 20th of the month to be effective the following month.
How can I cancel my dental policy?
You can terminate your policy by sending written notice to Delta Dental of Illinois at any time. The policy will end as of the last day of the monthly renewal period during which Delta Dental of Illinois receives your notice. You must still pay the premium for dental coverage provided during that renewal period. If you cancel your policy, or if your dental coverage is terminated for any reason, you may not re-enroll in the plan for 24 months.
How long are the rates guaranteed?
Rates are guaranteed for 12 months from the effective date.
Are there dental services that are not covered?
Yes, an example of a service that is not covered is orthodontics. There is no orthodontic coverage available with any of the individual and family plans. See your policy for a complete list of exclusions or view an overview of Exclusions & Limitations.
What is the difference between Delta Dental PPO, Delta Dental Premier and Non-participating/Out-of-Network?
Delta Dental of Illinois’ individual plans are based on the Delta Dental PPO network.
Delta Dental PPO is our PPO network. You will save the most and maximize your benefit dollars by choosing a Delta Dental PPO dentist. Delta Dental PPO dentists agree to our PPO fees, which are greatly reduced from what a dentist would typically charge, as payment in full. Delta Dental PPO is one of largest networks in the U.S.
Delta Dental Premier is a safety net to our Delta Dental PPO network. You will pay more out-of-pocket with a Delta Dental Premier dentist compared to a Delta Dental PPO dentist. However, you may save more money with a Delta Dental Premier dentist compared to a non-network dentist. Delta Dental Premier dentists agree to our maximum plan allowances, which may be lower in some cases than what a dentist would typically charge, as payment in full.
Delta Dental Premier and non-network dentists can bill for charges above the allowed Delta Dental PPO amount. This means that even if a procedure is covered at 100%, you may have out of pocket costs if you use a Delta Dental Premier or non-network dentists because they can bill for charges above the allowed Delta Dental PPO amount. However, Delta Dental Premier dentists cannot bill for charges above the allowed Delta Dental Premier amount, which means you may save money with a Delta Dental Premier dentist compared to a non-network dentist.
Is treatment for a missing tooth immediately covered?
If you lose a tooth through accident or injury, you are immediately covered for emergency treatment to relieve pain. However, for replacement of teeth that have been missing for some time through the use of bridges or dentures, there is a 12-month benefit waiting period. The waiting period is waived if you had coverage under a Delta Dental of Illinois plan within 60 days of your effective date in the individual plan.
How can I find out if my dentist is part of the Delta Dental network?
Use Delta Dental of Illinois' dentist search to find an in-network dentist in your area. You can narrow your search based on the Delta Dental network a dentist participates in. You will save the most if you use a Delta Dental PPO network dentist. You can also map network dentist locations and create a list of selected dentists, which can be printed, emailed or converted to a PDF.
Delta Dental of Illinois offers a smart way for members to find a dentist on their smart phone or tablet via the Delta Dental mobile app. Search by your current location using your device’s GPS, or search by an important address, like home or work. Your results can be filtered (gender, language spoken, accessibility) or sorted (distance, dentist name) to help you find a dentist that suits your specific needs and once you’ve selected a dentist, you can save your dentist to your contacts, call to schedule an appointment or navigate directly to the office. The Delta Dental mobile app is optimized for iOS and Android devices (smartphones and tablets) and is available for free to download in the App Store or Google Play Store
What is the difference between the Gold, Silver and Bronze dental plan options?
The biggest difference is in the co-insurance levels (the percentage that Delta Dental of Illinois pays) for various services that are covered. Please refer to the benefit summary for more information about each plan option.
Do I have to see a Delta Dental network dentist?
No, but you will save the most when you see a Delta Dental PPO dentist.
Where can I find my complete dental plan information?
Who should I contact with questions about my dental coverage?
For answers to any questions you may have about Delta Dental of Illinois individual and family dental plans, call us at 1-877-824-2776, 8:30 a.m. to 5:00 p.m. central time, Monday through Friday or contact us by email at email@example.com. For questions about your claims or customer service assistance, log in to Member Central, call 1-855-327-8336 or email firstname.lastname@example.org.
Need additional guidance?
For enrollment help or questions, please contact us at 877-824-2776, 8:30 a.m. to 5:00 p.m. central time, Monday through Friday or by email at email@example.com. For customer service or claims questions, please contact Delta Dental of Illinois Customer Service at 855-327-8336, Monday - Thursday 7:00 AM - 7:00 PM CST and Friday, 7:00 AM - 6:00 PM CST, or email firstname.lastname@example.org.