JavaScript must be enabled to use this site.

FAQs

Coronavirus (COVID-19) Frequently Asked Questions for Members

As a result of the recent COVID-19 pandemic, we are working to ensure our members are not adversely affected by this event in regard to their dental plan and/or DeltaVision* plan (if applicable). Our first concern is the health, safety and well-being of our members and those we serve.

Below is a list of frequently asked questions members may have that are specific to using their dental benefits and/or DeltaVision* plan (if a member receives coverage through their group/employer).

FAQs Regarding Dental Benefits

Will Delta Dental of Illinois’ customer service be available and will claims continue to be processed?

Does Delta Dental of Illinois intend to give members an extension on the amount of time they have to submit a claim?

Will dental provider offices be closed or office hours impacted due to COVID-19?

Why are premiums not being adjusted to accommodate the reduction in dental service?

How do members know what is a dental emergency?

Can a network dentist charge members for PPE (Personal Protective Equipment) expenses?

Should you postpone routine or non-emergency dental care after your dental office reopens?

DeltaCare Emergency Treatment

How do DeltaCare DHMO members receive emergency care?

FAQs Regarding DeltaVision* Benefits (if a member receives coverage through a group/employer)

Can members still use their vision benefits?

Will vision provider offices be closed or office hours impacted due to COVID-19?

For more questions on DeltaVision benefits.

Responses to above questions.

FAQs regarding dental benefits:

Will Delta Dental of Illinois’ customer service be available and will claims continue to be processed?

Our customer service team will continue to be available to answer any questions and assist our members during this time. Please note that we are adjusting our customer service hours to 7 a.m. to 5 p.m. Central Time, Monday through Friday, for group members, or members who receive dental benefits through a group or employer. Our customer services hours for individual members, or members who purchase a dental plan on their own, will continue to be 8 a.m. to 5 p.m. Central Time, Monday through Friday. Visit our Contact Us page for more information.

In addition, any claims we receive will also continue to be processed.

Providing a high level of service to our members, groups, brokers and dentists is a top priority, and it will be business as usual in terms of the service we provide you.

Does Delta Dental of Illinois intend to give members an extension on the amount of time they have to submit a claim?

Providers and members have 15 months from treatment date to submit a claim. We are extremely hopeful that COVID-19 will not delay claim submittals past this standard 15-month filing time. However, If a member or provider needs an extension on a claim due to this national emergency, we will handle these on appeal as needed.

Will dental provider offices be closed or office hours impacted due to COVID-19?

Dental offices nationwide are reopening to routine dental care. The American Dental Association is tracking state mandates on its website.  Here is what you may expect when you visit the dentist. If you are in a state where dental offices are only handling emergencies, here is a guide for what constitutes a dental emergency.

Why are premiums not being adjusted to accommodate the reduction in dental service?

Dental benefits are annual. Members don’t have services every month of the year and with dental offices reopening, there will be enough time remaining in the year to seek services. Additionally, dentists are able to address any emergency needs during this time, so members are covered should this need arise. 

How do members know what is a dental emergency?

Delta Dental of Illinois has developed a flyer to help members determine if a dental issue requires immediate attention or can wait.

Can a network dentist charge members for PPE (Personal Protective Equipment) expenses?

Delta Dental of Illinois’ network agreements do not allow network dentists to bill charges like this directly to our members. Non-network dentists are not required to follow these restrictions since they are not part of Delta Dental networks. If you’d like to find a Delta Dental PPO or Delta Dental Premier network dentist, please visit our Dentist Search at https://www.deltadentalil.com/find-a-provider/dental/

Should you postpone routine or non-emergency dental care after your dental office reopens?

Routine dental exams are crucial to your oral health and overall wellness. During the COVID-19 pandemic, you may have had to reschedule a preventive checkup. However, as restrictions are lifted, many dental offices are reopening to help patients meet their dental health needs. Infection control has always been a top priority for dental practices and updated guidelines to prevent the spread of COVID-19 have been set by the American Dental Association (ADA), the U.S. Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration (OSHA) and state health departments and agencies. Choosing when to return to the dentist is a personal choice and you may notice a few changes for added safety measures. Here is what you may experience as you return to the dentist.

DeltaCare Emergency Treatment

How do DeltaCare DHMO members receive emergency care?

DeltaCare DHMO members must select a primary dentist in the DeltaCare network and receive all services from that dentist. If specialty care is required, the primary dentist will refer the member to a specialist who is also a member of the DeltaCare network.  

In the case of emergency services, DeltaCare members are allowed one emergency visit per 12-month calendar year to a general dentist other than their selected primary DeltaCare dentist.

Emergency visits are for relief of pain only and any treatment needed related to the emergency condition must be completed by the selected DeltaCare primary dentist. For example, a root canal, crown or a tooth extraction are considered definitive treatment. Emergency treatment is a service such as a temporary filling, prescription or incision drain for the relief of pain, and would relate to palliative treatment ADA code 9110.

DeltaCare members will receive up to $50 reimbursement for emergency care. The payment that will be sent to the member directly upon receipt of a claim for the service rendered.  Anything over the $50.00 reimbursement is the member’s responsibility.

If the member elects to have full treatment performed by a dentist other than their selected primary DeltaCare dentist or a DeltaCare specialist referred by the DeltaCare primary dentist, the member will be responsible for the full treatment cost less the $50 emergency payment.

FAQs Regarding DeltaVision* benefits (if a member receives coverage through a group/employer):

Can members still use their vision benefits?

Yes. We encourage members to call their provider directly to verify store hours or closing.

Should you lose or break your glasses or require replacement contact lenses during this time, members can use online, in-network options, including Glasses.com, ContactsDirect, Ray-Ban.com, LensCrafters.com, and TargetOptical.com. Your benefits are applied on these sites during checkout and your glasses are mailed right to your home. Understanding the circumstances, many of these online providers are offering free expedited shipping and no-cost returns for extra convenience. Please check with online providers to verify offers.

Will vision provider offices be closed or office hours impacted due to COVID-19?

Yes. You should expect that numerous provider offices will be impacted due to federal, state and local restrictions, staffing, safety and other conditions. Call your provider directly to verify store hours or closing.

*DeltaVision is provided by ProTec Insurance Company, a wholly-owned subsidiary of Delta Dental of Illinois, in association with EyeMed Vision Care networks.