A parenting plan or statement of financial responsibility is required to verify which parent has primary coverage and which has secondary coverage for children.
It depends on who has financial health care responsibility and/or custody for the children. If a parent has primary health care responsibility for the children, their coverage will be primary. If parents have joint health care responsibility, the order of benefits is determined by who has custody. If both parents have joint health care responsibility and joint custody, the order of benefits is determined by the parent with the birthday earliest in the calendar year as the primary carrier.
If your former spouse has dental coverage that includes dependents, the children have coverage regardless of whether or not they reside with you or your spouse.
Yes. In some cases children may be covered by more than two dental insurance policies. They may be covered by one or both parents, as well as one or more stepparents. If either parent's insurance policy has a "non-duplication of benefits" provision, the coverage will be subject to contract limitations.
How frequently your dental plan will pay for your teeth cleaning depends on the benefits purchased by your employer. To learn about your specific coverage, Check Your Coverage. You will need to register or login to view.
Yes. Please see Individual Plans for dental benefit plans.
When you're covered by two dental policies, the non-duplication of benefits provision describes how a secondary policy may calculate its portion of payment. The secondary policy pays as much as it would pay if it were primary, minus the primary payment amount. For example, if the primary policy paid 80 percent and the secondary policy would cover 80 percent if it was primary, the secondary policy would not make an additional payment. If the primary policy paid 50 percent and the secondary policy would cover 80 percent, the secondary policy would pay up to 30 percent.
Delta Dental/Washington Dental Service covers you nationawide. If you see a Delta Dental member dentist, they'll submit the claims for you; however, if you see a non-member dentist you're responsible for having the dentist complete and sign claims forms. You'll also need to submit the claims to DD/WDS. Payment is based on actual charges or DD/WDS's maximum allowable fees for participating DD/WDS dentist, which ever is less.
Sealants are covered on permanent molars with no restorations or decay on the occlusal surface.
Your plan has an alternative allowance for fillings on your back teeth. If you have a white or tooth-colored filling placed on a back tooth, your plan will cover what a silver filling would cost. The difference in the cost between the silver and the white filling is your responsbility.
Delta Dental Plans Association is a national organization made up of local, nonprofit Delta Dental plans that provide employer groups with dental benefits coverage in all 50 states, the District of Columbia and Puerto Rico. Washington Dental Service is a member of the Delta Dental Plans Association.
Most employers do not allow address changes to be made directly through Washington Dental Service. Please first request this change through your employer. If you have a Washington Dental Service Individual Plan, please click on the the HDS link found on your Patient Home page after you've successfully logged in.
Yes; you may choose your own dentist. However, there are different networks to choose from, depending on which DD/WDS plan your employer has selected. To maximize the use of your benefits, see “Choosing a Dentist” in the “How to Use Your Program” section of your dental benefits booklet. You can find out whether your dentist is part of your plan’s network in the Find a Dentist section of this Web site. When you sign into the WDS site and click on Find a Dentist, you'll see the dentists available in your plan network.
Your member ID number is the unique number that identifies you as a Washington Dental Service subscriber under your dental plan. In some cases, this is your Social Security number; in others, it is a randomly selected identification number that has been assigned to you.
If you see a Washington Dental Service member dentist, the dental office will submit your claims for you. If your dentist is not a member dentist, you may send your claims to: Washington Dental Service P.O. Box 75983 Seattle, WA 98175
No; you should not have to use all CAPS to register. However, if you're having difficulty registering, you may try using all CAPS.
The Find a Dentist application that is on the Washington Dental Service Web site is only for Washington state providers. If you are searching for a dentist out of state - please use the DELTA DENTAL Find A Dentist by clicking here. You can also find the link to the Delta Dental National Dentist directory under the WDS Find A Dentist application - look for the green hyperlink called "Search the National Directory".
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Delta Dental Premier is our traditional fee-for-service plan. All Washington Dental Service member dentists automatically belong to this network. Delta Dental PPO is our preferred provider plan and has the largest network of PPO dentists in Washington state. PPO network dentists have agreed to provide care based on a lower average fee schedule. You can find out more about WDS’s choice of products and plan designs on this Web site.
Our Find a Dentist online dentist directory is linked to the Delta Dental Plans Association’s National Provider Directory where you can search for dentists outside of Washington state.
You can obtain a current Washington Dental Service directory of dentists at Find a Dentist.
A Washington Dental Service member dentist is a dentist who has signed an agreement with Washington Dental Service stipulating that he or she will provide dental treatment to subscribers covered by Washington Dental Service's group dental care programs. Washington Dental Service member dentists submit claims directly to Washington Dental Service for their patients.
A pre-treatment estimate, also known as a “predetermination of benefits,” is a service that Washington Dental Service provides to its enrollees. A predetermination is recommended for more extensive procedures such as crowns, wisdom tooth extractions, bridges, periodontal surgery, dental implants and dentures or if out of pocket expense is a concern. When your dentist predetermines treatment with Washington Dental Service, you’ll receive an estimate of your share of the cost and how much WDS may pay before treatment begins.
To predetermine treatment, your dentist sends Washington Dental Service a proposed treatment plan, along with relevant X-rays. WDS then checks to be sure which services are covered under your plan. Some dental work may be limited or excluded by your policy, and you will want to know what services may be covered before you proceed with treatment. We also calculate how any co-payments and dollar maximum limits might affect your share of the cost. You and your dentist then receive an estimate of the amount Washington Dental Service may pay for approved services and the amount you may be responsible for. Please note that a predetermination is not a guarantee of payment.
You can quickly download a claim form or you can obtain American Dental Association-approved claim forms from your dentist.
If you have questions about your specific dental plan coverage, click on the Check Your Coverage link in the navigation bar at the top of your portal/MySmile home page. For clarification about your explanation of benefits form, click on Your Dental Activity in the top navigation bar. If you still have questions, call Washington Dental Service’s Customer Service Department at (800) 554-1907 or e-mail email@example.com.
Please use the HIPAA Authorization form found here.
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