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Expanded coverage for chronic conditions

Our members’ 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. Group clients can continue to show their commitment to better health for their employees with this expanded program that offers extra gum and teeth cleanings. 

SmileWay Wellness Benefits not only help members stay healthy, they can help your clients avoid the costs of more serious dental procedures that can be required without additional preventive care. Offering expanded benefits for employees with chronic conditions is a great way for group clients to show their commitment to better health for all.

More covered conditions, better health

The health of teeth and gums is tied to overall wellness, and enrollees with certain chronic medical 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 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 under SmileWay Wellness Benefits

After they opt in to SmileWay Wellness Benefits, Delta Dental PPO enrollees 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 
  • 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 enrollees opt in

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

How to add SmileWay Wellness Benefits to a plan

This benefit is available as an add-on for all mid-size and large group plans with Delta Dental PPO. 

Chronic diseases or risk factors can cost U.S. employers $36.4 billion a year because of employees missing days of work, according to the Centers for Disease Control and Prevention. When employees keep up with regular cleanings, they can reduce the symptoms and complications of their chronic conditions.

Talk to your Delta Dental representative about adding Delta Dental’s SmileWay Wellness Benefits to your group clients’ plans.