The health of your teeth and gums is tied to your overall wellness. If you've been diagnosed with a chronic medical condition and have a higher risk of gum disease, you may benefit from additional teeth and gum cleanings throughout the year with SmileWay Wellness Benefits¹.
Many Delta Dental PPO™² employer-sponsored plans offer SmileWay Wellness Benefits — expanded dental coverage if you or a covered dependent have been diagnosed with one of the following chronic medical conditions:
If you qualify, SmileWay Wellness Benefits provide enhanced benefits under your dental PPO plan, at no extra cost to you.³ That means any member who qualifies under your plan can receive up to five cleanings per calendar or contract year, all covered at 100%. Review the table for details about the specific procedures that are included.
Procedure | Procedure code⁴ | Coverage per calendar/contract year |
---|---|---|
One periodontal scaling and root planing (deep cleaning to treat gum disease) — per quadrant | D4341 (4 or more teeth) |
100% coverage |
Plus up to four procedures from the following list (any combination) | ||
---|---|---|
Prophylaxis (teeth cleaning) | D1110 (adult) |
100% coverage |
Periodontal maintenance (cleaning to monitor and treat inflammation and infection after past gum surgery or treatment) | D4910 |
100% coverage |
Scaling in presence of moderate or severe gingival inflammation (plaque removal) | D4346 |
100% coverage |
You'll need to opt in to access the expanded coverage. To verify your coverage and opt in for yourself or a covered dependent, log in to your account and select SmileWay Wellness Benefits from the main menu. The link will display only if your organization has selected this coverage for your plan.
Select the Opt in button next to the eligible member’s name. Complete and submit the form, including the treating physician’s name and phone number. After 24 hours, you can start using your enhanced benefits.
Note: Adult dependents must opt in themselves through their own online account or by contacting us, unless they've authorized you to access their protected health information. They can grant authorization to you by logging in to their account, going to My account and selecting Yes for the "I authorize" statement. They can also mail a completed HIPAA authorization form (PDF, 38 KB) to Delta Dental.