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Word of Mouth

Benefits administrator blog from Delta Dental

Expanded coverage for chronic conditions

Your employees’ overall health and wellness is at the heart of what we do at Delta Dental. That’s why we’re expanding SmileWay® Wellness Benefits (known as SmileWay Enhanced Benefits in Texas) to include 14 chronic conditions. Helping your employees with chronic conditions get the extra teeth and gum cleanings they need is now easier than ever.  

Offering expanded benefits for employees with chronic conditions is a great way to show your commitment to better health for all. And the expanded coverage can also help your business avoid the costs of more serious dental procedures that can be required without additional preventive care.

More covered conditions, better health

The health of teeth and gums is tied to overall wellness, and enrollees with certain chronic conditions may benefit from additional teeth and gum cleanings. Regular dental maintenance and care can help prevent further health complications among people with chronic conditions.

That’s why SmileWay Wellness Benefits (known as SmileWay Enhanced Benefits in Texas) for Delta Dental PPO™ plans have expanded to cover more conditions. Covered members and their dependents who have been diagnosed with any of the following 14 chronic conditions now qualify:

  • Amyotrophic lateral sclerosis (ALS)
  • Cancer
  • Chronic kidney disease
  • Diabetes
  • Heart disease
  • Huntington’s disease
  • Joint replacement
  • Lupus
  • Opioid misuse and addiction
  • Parkinson’s disease
  • Rheumatoid arthritis
  • Sjögren’s syndrome
  • Stroke

What’s covered

After they opt in to SmileWay Wellness Benefits, your employees with qualifying chronic conditions are eligible for the following coverage:

  • 100% coverage each year for one periodontal scaling and root planing (deep cleaning to treat gum disease) — per quadrant
  • Plus 100% coverage each year for up to four procedures from the following list (any combination)
    • Prophylaxis (teeth cleaning)
    • Periodontal maintenance (cleaning to monitor and treat inflammation and infection after past gum surgery or treatment)
    • Scaling in presence of moderate or severe gingival inflammation (plaque removal)

How your employees can opt in to SmileWay Wellness Benefits

Opting in is simple, fast and free. For groups with this benefit, enrollees who have been diagnosed with one of the qualifying conditions can opt in online or by calling Customer Service.

Interested? How to add SmileWay Wellness Benefits to your plan

Show your commitment to better health for all your employees. SmileWay Wellness Benefits are available for you to add on to all PPO large group plans. Talk to your Delta Dental representative to learn how your group can benefit from Delta Dental’s SmileWay Wellness Benefits.

Promote SmileWay Wellness Benefits to your employees

If your group is covered with SmileWay Wellness Benefits, use the following strategies and resources to remind eligible members to opt in to take care of their oral health: