FYI

February is American Heart Month, making it a great time to talk to patients about the connection between oral health and overall health. For patients with certain medical conditions that can impact their oral health, SmileWay® Wellness Benefits¹ offer extra support.
 

What are SmileWay Wellness Benefits?

SmileWay Wellness Benefits allow Delta Dental members with certain pre-existing conditions to get extra cleanings each year. These benefits help members with chronic conditions maintain their oral and overall health, and include:
 

• 100% coverage each year for one scaling and root planing procedure per quadrant (D4341 or D4342)
• 100% coverage each year for four of the following in any combination:
  • Prophylaxis (D1110 or D1120)
  • Periodontal maintenance procedure (D4910)
  • Scaling in the presence of moderate or severe gingival inflammation (D4346)
     

Which conditions qualify patients for these benefits?

If a patient has any of these 14 chronic conditions, they may qualify for SmileWay Wellness Benefits:
 

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

How do patients enroll?

To qualify for these extra benefits, a patient must:
 

1. Be enrolled in a Delta Dental PPO™ plan
2. Belong to a group that offers SmileWay Wellness Benefits
3. Have one of the above qualifying diagnoses
4. Choose to opt into the benefit
    

Patients can opt in online or call Delta Dental’s Customer Service. You can verify patient’s eligibility and benefit status online in Provider Tools. Just look for one of these two notations when reviewing patients’ benefits:
 

• SW: The patient has enrolled in SmileWay Wellness Benefits.
• SW-P: The patient’s dental plan includes SmileWay Wellness Benefits, but they haven’t enrolled.
   

Learn more about SmileWay Wellness Benefits in this video.

¹ In TX, SmileWay Wellness Benefits are known as SmileWay Enhanced Benefits.