- Founded in 1954
- The nation’s leading provider of dental insurance
- 74 million subscribers
If you are looking for a Delta Dental Dentist, your search ends here
Smiley Dental has Delta Dental dentist that accepts all major plans of Delta Dental for a variety of different procedures. The major plans of Delta Dental are listed below
The Delta Dental PPO Plan
Smiley Dental accepts the Delta Dental PPO Plan
The Delta Dental PPO Plan is an employer sponsored plan that gives you access to a network of dentists that accept reduced fees for services covered in the plan. Most Smiley Dental dentists accept the Delta Dental PPO plan. This plan allows for you to search for your preferred dentist at a reduced rate.
Procedures that are Covered by the Delta Dental PPO Plan at Smiley Dental
The PPO plan follows the 100-80-50 percentage structure of dental care: 100% of the cost of preventive care procedures such as periodic examinations and X-rays,
- cleanings and periodontal maintenance, sealants, space maintainers, and application of fluoride are covered.
- 80% of the cost of basic procedures such as restorative fillings, endodontics, periodontics, and oral surgery are covered.
- 50% of the cost of major procedures such as implants, crowns and other cast restorations, and dentures and bridges are covered.
Calendar Year costs in the PPO Plan
Deductible : Typical deductibles are $50/person or $150/family but the amount may vary depending on your plan or your group/employer.
Out-of-Pocket Maximum (under age 19): The out of pocket maximums are typically $375/one member or $750/two or more members. However, these amounts may vary depending on your employer or group.
Annual Maximum (ages 19+) : Annual maximum typically ranges from $1500 to $6000 depending on your employer’s negotiated plan with Delta Dental.
The PPO Plan has many benefits
- The Delta Dental PPO plan allows for flexibility when searching for a dentist that follows this reduced expenses plan.
- Quality is ensured because all dentists are verified and approved of as credible.
- Claims payments go directly to the dentist of your choice from Delta Dental. You don’t have to worry about paying at Smiley Dental.
- Patients can save more than 35% when visiting a Delta Dental PPO network dentist rather than an out of network dentist.
- There is no balance billing. This means that the Smiley Dental dentist cannot charge you for the difference in their regular prices and your reduced prices.
The Delta Dental Premier Plan
Smiley Dental accepts the Delta Dental Premier Plan
The Delta Dental Premier Plan is the standard employer sponsored dental plan that allows for access to the largest network of dentists who have agreed to contracted fees determined by Delta Dental. This allows you to pay no more than your copay and deductible for covered services. Most Smiley Dental dentists accept the Premier Plus plan.
Coverage in the Delta Dental Premier Plan at Smiley Dental
The Premier Plan follows the 100-80-50 percentage structure of dental care
- 100% of the cost of preventive care procedures such as periodic examinations and X-rays, cleanings and periodontal maintenance, sealants, space maintainers, and application of fluoride are covered.
- 80% of the cost of basic procedures such as restorative fillings, endodontics, periodontics, and oral surgery are covered.
- 50% of the cost of major procedures such as implants, crowns and other cast restorations, and dentures and bridges are covered.
Calendar Year Costs in the Premier Plan
Deductible : Typical deductibles are $50/person or $150/family but the amount may vary depending on your plan or your group/employer.
Annual Maximum : Typical annual maximum is $1500/person. However, your annual maximum may vary depending on your employer or group;s dental plan.
The Premier Plan’s benefits
- Benefit levels including copayments, deductibles, maximums, and covered services can be adjusted.
- Credible, trusted dentists cannot “balance bill” payments in order to charge you the difference between standard pricing and what you are paying.
The Massachusetts Public Employees Fund
Smiley Dental accepts dental plans offered in the MPE fund
Public workers of Massachusetts have the option of two employer funded dental care plans: The Indemnity Plan and The Exclusive Provider Network (EPN) Plan. These plans are accepted by Smiley Dental and offer different services and benefits.
The EPN Plan
If you are enrolled in The Exclusive Provider Network Plan, we recommend that all dental work be done through Smiley Dental. This is because you will only receive plan benefits from dental associations that participate in the MPE EPN Plan. If dental work is done outside of this network, you will not be reimbursed by your insurance. The EPN Plan is administered by DSM Insurance, a branch of Delta Dental Massachusetts.
Coverage in the MPE EPN Plan
Diagnostic and Preventive Care procedures are completely covered by the EPN plan at Smiley Dental. This means that procedures such as periodic oral examinations, X-rays, cleanings, space maintainers, administration of fluoride, and more are covered. For further inquiry regarding covered services click the following link: MPE EPN plan paid in full services.
Other dental procedures may require a fixed amount of money to be paid when they are performed. For certain procedures, you will pay a portion of the cost of the actual service and the remaining cost will be covered by your insurance. These are called Co-paid services. Examples of these services at Smiley Dental are onlays, fillings, crowns, endodontics, periodontics, prosthodontics, repairs, oral surgery, and more. For further inquiry regarding co-paid services click the following link: MPE EPN Plan co-paid services.
Calendar Year Costs in the MPE EPN Plan
Annual Maximum : The annual maximum is typically $1500/person. However, this may vary depending on your employer or group’s specific dental insurance plan.
Benefits to the MPE EPN Plan
- Payments for preventive care and diagnostic services do not contribute to your annual maximum.
- All preventive care and diagnostic services are covered by your insurance, there are no deductibles or copayments necessary at Smiley Dental.
- In times of emergency, you still must report to an MPE EPN Plan dentist if you want services to be covered or co-paid.
Important distinctions
- Smiley Dental will submit all claims to the MPE unit at Delta Dental of Massachusetts. You will receive an Explanation of Benefits statement whenever services are paid for under the EPN Plan. It is your duty to carefully review these files and if there are any discrepancies, they should be reported to the MPE Unit at (800) 553-6277.
- Prior to receiving any services you should verify that you are enrolled in the MPE EPN Plan. You can do this by calling the Fund Office at (800) 325-5214.
The Indemnity Plan
If you are enrolled in the Indemnity Plan, we recommend you receive dental services from Smiley Dental. The Indemnity Plan allows for you and all family members to receive services at a discounted rate. Delta Dental has fixed contributions to dental procedures that they will pay to your dentist and you must pay the remaining balance. It is advantageous to receive dental work with Smiley Dental because we accept Delta Dental meaning that our fee with Delta Dental may be at a discounted rate than a dentist’s fee that doesn’t participate in Delta Dental.
Coverage in The Indemnity Plan
Smiley Dental accepts The Indemnity Plan and this allows for Delta Dental to pay fixed amounts to the services that you receive. The difference between Smiley Dental’s accepted rate with Delta Dental and the fixed amount that Delta Dental pays must be paid by you. A portion of every service is covered in The Indemnity Plan. Examples of popular services would be fillings, X-rays, fluoride, crowns, oral surgeries, dentures, periodontics, and more. For more information regarding payments made by The Indemnity Plan, please click the following link: The Indemnity Plan Reimbursement Table.
Calendar Year Costs in The Indemnity Plan
Annual Maximum : The typical annual maximum is $1500/each family member. However, this may vary depending on your employer or group.
Benefits to The Indemnity Plan
- The Indemnity Plan includes all family members with its discounted rates.
- Smiley Dental accepts Delta Dental. This means that the difference between The Indemnity Plan’s reimbursement and the service fee will be smaller than at a dentist that does not participate with Delta Dental.
- The Indemnity Plan’s fixed reimbursement amounts will apply to dentists that do not accept Delta Dental.
Important Distinctions
- Smiley Dental will submit all claims for reimbursement to Delta Dental Massachusetts. You will receive an Explanation of Benefits (EOB) form after your claim is filed by your dentist. The patient payment column of the EOB form will show you how much you owe your dentist.
- It is your duty to locate any discrepancies in the EOB form and report it to the MPE Unit at (800) 553-6277.
Smiley Dental accepts Delta Dental of Massachusetts and Delta Dental of all other states: Delta Dental Insurance Company, Delta Dental of Arizona, Delta Dental of Arkansas, Delta Dental of California, Delta Dental of Colorado, Delta Dental of Delaware, Delta Dental of Idaho, Delta Dental of Illinois, Delta Dental of Indiana, Delta Dental of Iowa, Delta Dental of Kansas, Delta Dental of Kentucky, Delta Dental of Michigan, Delta Dental of Minnesota, Delta Dental of Missouri, Delta Dental of Nebraska, Delta Dental of New Jersey, Delta Dental of New Mexico, Delta Dental of New York, Delta Dental of North Carolina, Delta Dental of Ohio, Delta Dental of Oklahoma, Delta Dental of Oregon, Delta Dental of Pennsylvania, Delta Dental of Puerto Rico, Delta Dental of Rhode Island, Delta Dental of South Dakota, Delta Dental of Tennessee, Delta Dental of the District of Columbia, Delta Dental of Virginia, Delta Dental of Washington, Delta Dental of West Virginia, Delta Dental of Wisconsin, Delta Dental of Wyoming, Delta Dental Plan of Maine, Delta Dental Plan of New Hampshire, Delta Dental Plan of Vermont, and Hawaii Dental Service. For further clarification regarding whether Smiley Dental accepts the Delta Dental of your state, consult Delta Dental Member Companies by State.