Individual and Family plans are for any resident of WA State. Individual plans are designed for anybody who does not have dental coverage through their current employer or would like additional dental coverage for themselves or for their family.
Delta Dental of Washington currently offers seven different plans for both individuals and families. Both individuals and families are eligible for all seven of our plan offerings.
Individual and Family plans are administered by Wyssta Services, Inc., a health care benefit manager acting on behalf of Delta Dental of Washington. As our Health Care Benefit Manager, Wyssta Services, Inc. performs certain tasks on Delta Dental of Washington’s behalf, such as enrollment, claims processing, and customer service. For more information regarding the role of a health care benefit manager, please visit our website at www.deltadentalwa.com/tools-and-resources/health-care-benefit-manager.
Delta Dental of Washington Individual and Family Plans
Frequently Asked Questions
Enrolling - Dental
Plans do not start mid-month. Plans are available to start the first day of the following month or the first day of the second month after purchase.
The monthly premium depends on how many people are covered in your household. And depends on the plan selected, the more the plan covers, the higher the price. For example, people who only want a plan to cover simple cleanings might select the Basic plan. Others may prefer a plan that covers three cleanings for gum disease, they might select the Premium plan. Please refer to our Individual and Family Dental Plans page for plan costs.
Please visit our Individual and Family Dental Plans page to get a quote and enroll in a plan.
Please call 844-764-5301 to speak with a representative about enrolling in a new Individual and Family plan, Monday - Friday from 8am – 5pm PT.
All our Individual and Family plans include Delta Dental of Washington’s largest network of providers. As a plan member you have access to discounted charges on common dental treatments like crowns, root canals, exams & cleanings, fillings, implants and more (except Basic Plan is limited to exams & cleanings, fillings). Check out our Compare Treatment Costs Tool to see what the average cost of a service is with and without an Individual and Family dental plan.
Prior coverage must meet all the following:
- Prior coverage included ortho for all members on the policy
- Must have continuous 12-months coverage including Plus Ortho plan. With no more than 63-day lapse between plans.
Acceptable documentation:
- Declarations page
- Letter of experience or other documentation from prior carrier
- DDWA customer service if prior DDWA group plan
Yes, you may have as many individual dental benefit plans as you would like in the state of Washington. For example, you can have both a Delta Dental Individual plan and Medicare plan or a plan through your employer; the Delta Dental of Washington (DDWA) Individual plan does not coordinate benefits.
Original Medicare does NOT cover dental care. Medicare Advantage may offer some extra benefits like vision, hearing, and dental services, but may only offer limited coverage for certain benefits. Refer to the Medicare site to view your Medicare plan information or learn more about Medicare and our plans recommended for retirees here.
Check your current Delta Dental policy. Note that Delta Dental plan benefits are accepted by all participating Delta Dental providers. If your primary residence is in Washington state, you can enroll in a Delta Dental of Washington plan according to your current plan contract.
No, your information does not transfer.
Getting Started - Dental
Your member ID number is a unique number that identifies you as a Delta Dental subscriber under your dental plan. It is an 11-digit randomly selected identification number that has been assigned.
When registering for your account on https://my.deltadentalcoversme.com/self-service/registration, you have the option to select “I don’t have my Member ID”, located on the bottom left corner of the page. From there, you will be able to input your coverage information to locate your Member ID.
Alternatively, you may call Customer Service at (888) 899-3734 or review your declaration page to find your Policy Number.
After enrolling on the Delta Dental Covers Me website or over the phone, we recommend waiting 48 hours from the time of enrollment before registering to allow our systems to fully update with your information. All that is needed to register is your Policy Number/Member ID: with that you can create your username and password on https://my.deltadentalcoversme.com/self-service/registration. If you do not know your Policy Number/Member ID, please refer to the previous question, What is my Policy Number/Member ID and where can I find it?.
Please visit https://my.deltadentalcoversme.com/ and click "Sign In" on the top righthand corner of the page. Note that you will need to reset your password the first time you sign in. Use your current login info to begin. After logging in, click on “My Account” in the Quick Links section at the top righthand corner of the homepage to update your address, phone, billing, communication preferences, password, mobile/email, and other account preferences. To view your plan, click on “Benefits” > “Coverage Overview” from the menu bar at top.
If you do not already have an online account, select "Register” and input your member information.
By Phone
Please call (888) 899-3734 to speak with a sales representative Monday - Friday from 8am – 5pm PT.
Online:
When processing an application, the very first month of premium payment is due at the time of enrollment. Future payments will be deducted on the 27th of each month which pays for the next month of coverage. (Example: September 27th billing date pays for October coverage) We accept Electronic Funds Transfer (EFT) from a checking or savings account. We also accept debit or credit cards from Visa, Discover, or Mastercard. Currently, we do not accept American Express.
- One-time payment
For one-time payments, please visit https://my.deltadentalcoversme.com/one-time-payment/member-information and fill out the form with your Member ID, Date of Birth, and Zip Code. - Recurring payment
When you purchase a policy, the payment information you provide is saved on file and used for recurring payments automatically at the frequency you’ve chosen (monthly, semi-annual, or annual.) You can change your payment method at any time, but payments need to remain automatically drawn unless you choose to pay for the whole year at once. You can manage your payment preferences by logging into your My Delta Dental Covers Me Account. - Note that if you have enrolled for a Washington Health Benefit Exchange policy, a recurring payment can be set up by calling our Customer Service team at (888) 899-3734 during weekdays from 8am-5pm PT.
By Mail:
If you enrolled through paper application, you will receive an invoice (12-month payment) for your renewal.
All requests to add or remove a dependent must be submitted in writing via email, fax, or mail.
Email: Use the email us form on the My Delta Dental Covers Me Contact Us page
Fax: 1-800-807-1970
Mailing Address: P.O. Box 103, Stevens Point, WI 54481-0103
Within your request, be sure to include your first and last name, date of birth, full address, policy number, and dependent information including first and last name, date of birth, full address, requested effective date, and reason for adding or removing (newborn or adoption).
Policies are termed the last day of the month for which they are received. To change plans at renewal, call the number below or submit a written cancellation request before the policy’s renewal date. The policy will end on the last day of the month before the renewal date. Then, complete and submit an application for the new plan. If the new application is received before the end of the month, you may choose the 1st of the following month for an effective date.
By Phone
Please call (888) 899-3734 to speak with a sales representative Monday - Friday from 8am – 5pm PT.
By Mail
Submit a new paper application to PO Box 103, Stevens Point, WI 54481-0103
If you choose not to renew your coverage, your request must be submitted in writing via email, fax, or mail.
Email: Use the email us form on the My Delta Dental Covers Me Contact Us page
Fax: 1-800-807-1970
Mailing Address: P.O. Box 103, Stevens Point, WI 54481-0103
Within your request, be sure to include your first and last name, date of birth, full address, policy number, reason for cancellation, and requested termination date.
Policies are termed the last day of the month for which they are received.
Note that many of our dental policies require a 12-month commitment. We recommend reviewing your policy contract for state- and policy-specific guidelines on the requirements and instructions for termination.
Using Benefits
No, you do not need to provide your Policy Number/Member ID when you go to the dentist. If your account is active, they will be able to look you up in the system. If you recently purchased your policy, it may take a few days for the system to recognize you as an active member. In this case, you may inform your dentist of your Policy Number/Member ID if you need to use your benefits before then.
DDWA does not make appointments. Please contact your dentist or use our Find a Dentist tool to find an in-network dentist.
Check out our Find a Dentist tool to search for a dentist within your location.
A pre-determination is a claim form that your dentist will fill out and submit that lays out the treatment codes and details they are anticipating you will need. It will process through your policy, determine what benefits would be covered if those services are completed, and send a copy to both you and your dentist. Once received, these pre-determinations typically process in 7-10 business days. If you would prefer to track them online, they are available in the Claims section of your My Delta Dental Covers Me Account or can be discussed by calling Consumer Support at (888) 899-3734.
To get a predetermination, simply tell your dentist you would like a cost estimate for the procedure they are recommending. Your dentist will contact us and request a predetermination. This will allow you and your dentist to discuss treatment options that are within your budget, while also getting the most out of your dental benefits.
An Explanation of Benefits is a document you receive that explains what treatments and/or services were covered and paid for by your insurance plan. Your EOB is not a bill. It simply outlines the treatment and/or services you received from your dentist and the amount your insurance paid toward those costs. You will get your EOB after your visit to your dentist. There are 2 ways to receive your EOB:
- Electronically: login to your online My Delta Dental Covers Me Account. After logging in, click on “Claims Status” in the Quick Links section at the top righthand corner of the homepage and select “My EOBs” to view or print your EOBs.
- By Mail: If you haven’t signed up for paperless communications, you will receive your EOB in the mail.
Understanding Benefits
For certain plans and covered procedures, a 12-month waiting period applies. This means that DDWA will not pay towards any of these procedures until you have been enrolled in this policy for 12 continuous months. Any waiting periods will be waived for you if you were covered under another insured dental plan for at least 12 continuous months before you enrolled in this plan, but only if there was no more than a 63-day gap between your previous plan and this plan.
Our plans are designed to be effective and affordable with focus on building lifelong oral health. Only getting dental when something is wrong is expensive for the member and the plan, that is the purpose of waiting period, to reduce cost and reward regular visits to the dentist. It is important to note that preventive care such as exams, x-rays, cleanings never have a wait period on any of our plans. And there are two plans, Ascent and Clear, that are not subject to wait periods on any covered procedure. Learn more about our no waiting period plans.
The annual dollar maximum on a plan is the most the plan will pay for each covered individual in a benefit year.
On the Plus Ortho Plan, each covered individual on the plan has their own yearly maximum of $1,500 to be used towards services throughout the benefit year. With the “Family Share Maximum Benefit,” you are given an additional $250 Maximum Benefit for each person on the plan, up to five individuals. This additional money is pooled together and any individual who uses up their personal maximum can utilize the money in the shared maximum bank. Please see the chart below for a visual explanation.
Family Share Chart
| # of Covered Members | Family Share Maximum | Per Person Maximum Benefits |
|---|---|---|
| 1 | $250 | $1500 |
| 2 | $500 | $1500 |
| 3 | $750 | $1500 |
| 4 | $1000 | $1500 |
| 5 or more | $1250 | $1500 |
These services are excluded from coverage to assist in keeping premiums affordable.
Getting Started - Vision
Delta Dental of Washington, in partnership with VSP Vision Care, offers two affordable Individual and Family vision plan options, DeltaVision Essential 150® and Delta Vision Brilliance 200®, to add to your dental plan at checkout. During checkout on deltadentalcoversme.com you will be prompted with the option to add one of our two vision plans. If you are not interested in purchasing a DeltaVision® plan at this time, you may select “Continue with Dental Only” at the bottom righthand corner of your screen during the checkout process. Learn more about our DeltaVision® plans.
DeltaVision® can be added at your dental plan at any time. To add DeltaVision® to your current dental plan, please call (844) 764-5350.
Create and Manage your Account
- Go to https://www.vsp.com/
- Click on Create an Account.
- Add your 11-digit vision member ID. You can find your member ID on your vision declaration page or contact member support 888-899-3734.
- Fill in all required fields.
- At the bottom of the page, click on “Create an Account” to complete the account. You will then be able to manage your account using this same login information.
Currently, members cannot view their DeltaVision® benefits on their Delta Dental Covers Me Account. Please refer to the instructions in the previous question to setup and manage your DeltaVision® Account on VSP.com.
