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  • Wellcare

  • Wellcare Medicare Advantage Members

    California Dental Dual Special Needs Plan

All about your plan

Wellcare has partnered with Delta Dental to provide dental benefits under your plan. Your dental plan has set costs, with no annual maximum or waiting periods, and you can choose your dentist from any participating provider.  
 
Codes listed in your Dual Special Needs Plan Benefits Summary (found below under Review your benefits) are covered under Wellcare’s Dual Special Needs Plan extra benefits program. You should also be eligible for basic and comprehensive dental benefits under CA Medi-Cal Dental.  Procedures not covered by Wellcare’s Dual Special Needs Plan may be covered under your Medi-Cal Dental state benefit. For more information on your state-covered benefits under Medi-Cal Dental, refer to www.smilecalifornia.org or call 1-800-322-6384. 

  • Plan ahead and stick to your budget

    Get your costs upfront. You’ll have a list of copayments for every covered procedure, so you’ll know all your costs, for preventive, basic and major services.

  • Choose your primary care dentist

    Select a skilled primary care dentist from our network, all of whom also accept Medi-Cal Dental fee for service program. Your primary care dentist will provide most of your treatment and coordinate any necessary specialist referrals for benefits covered under Medi-Cal and your Wellcare Dual Special Needs Plan.² 

    You'll have one dentist for all your needs, with the flexibility to change your network dentist at any time. (Changes requested by the 21st of the month are effective the first day of the following month.)

Find a dentist

  • Review your benefits

    Your out-of-pocket costs for all dental procedures are explained in your plan booklet. The copayment — the amount you owe your dentist — is listed next to the name of each procedure. Procedures not listed in your copay schedule are not covered.  Still not sure?  Ask your provider to submit a pre-treatment estimate to Delta Dental.  You and your provider will receive a  copy of your pre-treatment estimate review. 

    Be sure to read your booklet carefully for important details that may affect your costs, such as exclusions.

    Delta Dental plan benefit highlights:

    • Predictable costs. — Covered services are available at no cost to you, with no deductible or annual benefit limit. This makes it easy to track your out-of-pocket costs.
    • No annual maximum — Get the dental care you need and don’t worry about exceeding your annual maximum — there isn’t one!
    • No waiting periods — Your dental benefits are included as part of your enrollment in the Wellcare Medicare Advantage plan, so you don’t have to wait. You can begin taking advantage of your coverage right away.
    • Choose the right dentist for you. — With WellCare, it’s easy for you to get the best dental care you need for your specific situation. You must visit your assigned dentist, but you’re free to choose a new dentist at any time. View your dental directory.

    Note that some services are either limited or excluded. If a procedure is not listed in the copay schedule, it is not covered.

     2024 Dual Special Needs Plan Benefits Summary (PDF, 153KB)

    You can visit a plan contracted dentist to use your dental benefits. Your ID card and the welcome packet that was mailed to you have your assigned dentist’s information. If you want to change your dentist, just call Delta Dental at 855-643-8515. Please note that provider changes made prior to the 20th of the month will be effective the first of the month following the date the requested change was made.

    There are no costs for covered services. Please review benefit summary to see which services are covered and any limitations or exclusions. Services not listed in the copay scheduled are considered non-covered services.

    Not sure what is covered and the cost? Ask your provider to submit a pre-treatment estimate.

    Still have questions about coverage and costs? You can ask your dentist to submit a pre-treatment estimate before getting care.

  • Find a dentist

    Looking for a dentist? Find the one that’s right for you.

    Please note: Clicking the Find a dentist button will take you to the main Delta Dental website, deltadentalins.com. You may find information on our main site that is not specific to your plan and benefits.

  • How to refine your search results

    • Search by languages spoken. Different dentists may offer services in a variety of languages. To search by languages spoken, click the Refine Search button on the search results page and select the Languages drop-down. Pick your preferred language from the list, then hit Apply.
    • Filter your results. Refine your search results by categories such as specialty, language spoken and network.

    DentaQual helps members see how dentists rank where it matters

      Learn about DentaQual (PDF, 291KB)

Delta Dental is a registered mark of Delta Dental Plans Association.

  1. In WY, you do not need to select a primary care dentist, but you must visit a DHMO dentist to receive benefits. In the following states, you can maximize your savings when you visit a DHMO dentist, although you may visit any licensed dentist and receive out-of-network coverage: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT. Refer to your plan booklet for details about your out-of-network benefits.
  2. Most services not performed by your primary care dentist must be authorized by Delta Dental. In some states, specialty care benefits are only available for services performed by a DHMO specialist. Refer to your plan booklet for more information.
  3. In the following states, you can change your dentist any time without contacting Delta Dental: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT, WY.

Last updated 10/03/2022