How much of your procedure will Delta Dental cover? Pre-treatment estimates help you plan ahead.
Pre-treatment estimates, sometimes called pre-determinations or pre-authorizations, are estimates dentists can request to help patients find out how much Delta Dental will pay for proposed procedures.
Any work can be submitted for a pre-treatment estimate, but estimates are most often requested – and recommended – for costly procedures such as crowns, wisdom tooth extractions, build-ups, bridges, implants, dentures, perio services and oral surgery.
Once your dentist requests a pre-treatment estimate, Delta Dental will review the proposed treatment plan, your x-rays, clinical notes, diagnosis, and what your benefit plan covers. After analyzing these materials, Delta Dental will send a statement to your dentist that estimates what your benefits will cover and what it may cost you out-of-pocket. The estimate is based on your current plan benefits, your eligibility and the amount remaining in your annual maximum and deductible requirements.
Pre-treatment estimates can help you budget for dental procedures. They can also help you and your dentist decide how to proceed with a treatment. Your dentist may be able to suggest alternate treatments and procedures based on what your plan will and won’t cover.
Knowing what to expect for costs before the procedure is just one more way to avoid anxiety about the visiting the dentist.