Dental Implant Policy
Documents Related to Dental Implant Policy
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Special Rules for Dental Implants:
If the Fund’s dental advisor determines that an implant is necessary to maintain a Patient’s dental health and function the Plan will pay the cost of the implant under the Medical Provisions of the Plan. Services related to implants, including but not limited to extractions and abutments, will remain subject to the rules for Dental Benefits.
IMPORTANT NOTE: A Provider, Participant, or Patient should submit a claim for implants to the Plan’s dental advisor for determination of eligibility before installation of the implants. Failure to do so could leave the Provider and Patient with no source of payment of the implants if the plan’s dental advisor subsequently determines that the implants do not qualify for coverage as a Medical Benefit. Please note that Delta Dental will administer the payment of the dental implants as a medical claim and pay the claim outside of the annual maximum in order to utilize the Delta Dental network discounts.