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Individual & Family Plans


 

Learn More | Frequent Questions

Enroll online by clicking the green 'Enroll' button below the table of your selected plan. Or you can download an application (.pdf) and send it to us at Delta Dental of South Dakota, PO Box 1157, Pierre, SD 57501 

Delta Dental of South Dakota individual/family policies are available to residents of South Dakota. Coverage is also available for your spouse and/or dependent children.

Your coverage would terminate at the end of the month in which you changed residency. The plan is open to South Dakota residents only, which means that you must reside in South Dakota at least six months of the year.

Yes. Your Delta Dental coverage travels with you. Common examples are:

  • A secondary residence outside of South Dakota
  • Full-time students attending college in another state
  • Traveling outside the state of South Dakota

For the Traditional (1040) plan you can pay monthly by credit card or electronic funds transfer. You can also pay by an annual check.

For the Standard (502) and Enhanced (503) plans you can pay monthly by credit card, electronic funds transfer, or check.

For the Traditional (1040) plan: on or after the 5th of each month

For the Standard (502) or Enhanced (503) plans: on or after the 20th of each month.

No, you will not receive a bill each month. You will receive an email each month notifying you that your credit card or bank account has been charged.

Your policy will be effective on the first day of the month following approval of your application.

Rates are guaranteed through December 31. Thereafter, enrollees will receive a rate change notification by mid-November of each year for the following year’s rates.

No. It is common practice to show only the subscriber’s name on the identification card. Dental offices are familiar with this practice and will be able to confirm dependent benefits with the subscriber’s information.

Finding a participating dentist is easy by using our "Find A Dentist" tool. Select the network "Delta Dental Premier" or “Delta Dental PPO”.

Yes, you may go to any dentist you choose. However, to get the most from your benefits, choose a dentist who participates in one of Delta Dental’s networks.

Dentists in the Delta Dental PPO network offer significant fee reductions to Delta Dental patients. This minimizes out-of-pocket costs.

Members can also choose a dentist from the Delta Dental Premier network. More than 98% of South Dakota dentists and more than 75% of dentists nationwide belong to this network.

To locate a dentist in your area use our "Find A Dentist" tool online.

Your coverage year is the 12-month period (January – December) over which your deductible, maximums and other provisions apply.

Yes, the individual/family plans have a one year wait for coverage for endodontics (root canals), periodontics (gum and bone diseases) and major services like crowns, bridges, dentures and implants.

On the Standard (502) and Enhanced (503) plans the waiting period does not apply to children under 19.

A waiting period is the period of time during which a member must wait before starting to receive benefits.

Yes. Whether you were the primary subscriber or a covered dependent, waiting periods will be waived for those who have been covered by a dental plan for at least the last 12 consecutive months with no break in coverage.

A deductible is the amount enrollees must pay toward treatment before their dental benefits are paid. The deductible, plus co-insurance and any amount over the annual maximum is often referred to as the enrollee’s out-of-pocket costs. The deductible applies to each person enrolled in your plan.

The annual maximum benefit is for each person enrolled in the dental plan.

Yes. Please see the exclusions page for details.

If you have a history of periodontal services and have satisfied the one year waiting period, periodontal maintenance is covered. You can receive two periodontal maintenance services, or two routine cleanings or one of each, but you cannot receive more than two services total during your coverage year. Additional benefits may apply through our Health through Oral Wellness program.

If you lose a tooth through accident or injury, you are immediately covered for emergency treatment to relieve pain. However, for replacement of teeth that have been missing for some time through the use of bridges or dentures there is a one year waiting period.

Dental sealants are a benefit once in a lifetime for unrestored first and second permanent molars of children up to age 16. Additional benefits may apply through our Health through Oral Wellness program

Fillings consist of two different types: a silver material called amalgam, or a tooth-colored material called composite.

If you need fillings on back (posterior) teeth, only silver fillings are covered. If you choose to have your dentist use the tooth-colored material, you will have to pay the difference in cost.

Fillings are a benefit once for each tooth surface in a 24 month interval from the date the service was last performed on that specific tooth surface.

Yes, after a one year waiting period.

No. Cosmetic procedures are not a covered benefit.

Yes, but waiting periods and limitations may apply.

Medically necessary is an extremely rare circumstance as determined by a third party dental consultant and in all cases requires a preauthorization.

The removal (extraction) of wisdom teeth (third molars) must meet the medically necessary requirements in order to be a benefit. The medically necessary requirements are: surgical removal of impacted third molars is limited to patients with evidence of pathology. This includes, but not limited to, unrestorable caries, non-treatable pulpal and or periapical pathology, cellulitis, abscess, resorption of tooth or adjacent teeth, fractured tooth, teeth that involve cyst/tumors or teeth involving reconstructive surgeries. Your dentist must send a predetermination of benefits to Delta Dental.

Medically necessary orthodontic services are related to and an integral part of the medical and surgical correction of a functional impairment resulting from a congenital defect or anomaly, such as but not limited to, the correction of a congenital defect like cleft palate, etc. Your dentist must send a predetermination of benefits to Delta Dental.

Once you have spent $350 per child or $700 for two or more children in a coverage year all covered services will be covered at 100%.

The out-of-pocket maximum is made up of deductibles and co-insurance. If you see a non-participating dentist, the difference between what they charge and what Delta Dental allows will not apply to the out-of-pocket maximum.

The out-of-pocket maximum only applies to children up to age 19.