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Paying For Your Care

With the DHMO it is easy to estimate your out-of-pocket costs because your benefits are listed in the "Description of Benefits and Copayments" section of the EOC booklet (issued by Delta Dental), which can be found on our website.

Copays

"Copay" is a fixed-dollar amount that you pay your contract dentist for certain eligible expenses at the time the service is provided.

Coordination of Benefits

For the general COB rules, see page 51. See the Evidence of Coverage (EOC) provided by Delta Dental for specific COB rules that apply to the DHMO Plan.

Filed Fees

Any procedure not listed in the EOC is considered a non-covered expenses and you will be charged a "Filed Fee" for that service. This means the fee your contract dentist will charge you has been filed with Delta Dental and your dentist cannot charge you more than the "Filed Fee."

Optional Fees

You will incur an additional charge if you request your contract dentist to perform an alternative procedure that satisfies the same dental need as a covered procedure (i.e., a composite filling instead of an amalgam filling). Your contract dentist will charge you the difference between his/her "Filed Fee" for the "optional" procedure and the "Filed Fee" for the "covered" procedure, plus any applicable "copayment" for the covered procedure.