Have you visited the dentist yet this year? The Joint Health Management Board (JHMB) is here to remind you about the current tiered PPO dental plan structure under Delta Dental®, and how you can make sure you maintain your level of coverage.
What Is Delta Dental’s Tiered Plan Structure?
In the first year of eligibility under the current tiered incentive plan, Delta Dental pays 70% of your allowance for major services and all covered diagnostic, preventative, and basic services. Visiting the dentist at least once during the year increases that coverage by 10% for the next year—successive years can stack to result in 100% coinsurance. However, if you do not use your plan during the calendar year, you will see a 10% decrease in your coverage instead. Furthermore, if you become ineligible for benefits, the percentage will drop back to 70% once you regain eligibility.
Note that those who were enrolled in Delta Dental as of December 31, 2023, started at 100% coverage as of January 1, 2024. However, those enrollees could potentially see their coverage decrease to 90% if they don’t visit the dentist before the end of the calendar year.
What This Means for You
This structure incentivizes you to visit the dentist at least once per year to ensure that you maintain the increased coinsurance percentage. However, if you skip your yearly dentist visit, your Delta Dental plan’s coverage will decrease instead.
In other words, if you have Delta Dental coverage, make sure to use it so you don’t reduce it.
Learn more by checking your account information, and find a PPO dentist through the Delta Dental insurance website.
