Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania and affiliates
Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania and affiliates
SmileWay® Wellness Benefits
Protect your overall health when you're at risk
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:
- Amyotrophic 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
More covered cleanings every year
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.
Expanded coverage with SmileWay Wellness Benefits
| 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 |
How to enroll
You'll need to opt in to access the expanded coverage. To verify your coverage and opt in to SmileWay Wellness Benefits for yourself or a covered dependent, log in to your account. Select Benefits overview (or Benefits) and then Optional Benefits. From there, select Opt In next to the qualifying member's name.
Complete the opt-in form and include your physician's name and phone number. Select the Opt In button to finish enrolling in SmileWay Wellness Benefits. After 24 hours, you can start using your enhanced benefits.
Note: Adult dependents must opt in themselves, unless they've authorized you to access their protected health information. They can grant authorization to you by mailing a completed HIPAA authorization form (PDF, 38 KB) to Delta Dental, or they can log in to their own online account and go to My account.
If you need assistance with opting in, or if you have other questions about SmileWay Wellness Benefits, contact us.
- SmileWay Wellness Benefits are not included under all plans. Known as SmileWay® Enhanced Benefits in Texas.
- Delta Dental PPO plans are underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan.
- SmileWay Wellness Benefits are subject to any applicable maximums and deductibles under the terms and conditions outlined in your Evidence of Coverage. Please review your plan booklet for specific details about your coverage.
- Current Dental Terminology (CDT) coding and nomenclature are the copyright and a trademark of the American Dental Association, all rights reserved.