Benefits

How Do I Find a Participating Dental Provider in My Preferred Network?

(Delta Dental NY Select and Delta Dental PPO Networks)

If you live in New York, your Delta Dental network is the Delta Dental NY Select Network.

If you live outside of New York, your Delta Dental network is the Delta Dental PPO Network.

Use the Delta Dental provider search tool at www.deltadentalins.com to search for a dentist within the Delta Dental NY Select or Delta Dental PPO networks by area, language, and specialty.

Delta Dental customer service representatives are available to help Monday through Friday, 8:00 am to 8:00 pm (ET) at the Delta Dental DC 37 Customer Service Center for DC 37 members by calling 1 (888) 523-DC37 (3237).

Who Is Eligible for Coverage?

Eligible Full-Time Participants, retirees, and their covered dependents are covered for all covered dental services received from a Delta New York Select Network dentist (participants residing in New York) or a Delta Dental PPO Network dentist (participants residing outside New York) up to the $1,700 annual maximum per eligible participant. If a non-participating provider is used, full-time eligible participants will be responsible for any difference between the plan’s out-of-network allowance for dental services and the provider’s actual charges.

Eligible Part-Time Participants are covered 75% (with 25% coinsurance copay) for all covered dental services received from a Delta New York Select Network dentist (participants residing in New York State) or a Delta Dental PPO dentist (participants residing outside New York State) up to the $1,700 annual maximum per eligible participant. If a non-participating provider is used, part-time eligible participants will be responsible for any difference between the plan’s out-of-network allowance for dental services and the provider’s actual charges, in addition to the 25% coinsurance.

Please contact the toll-free Delta Dental Customer Service Center at (888) 523-DC37 (3237) to determine your eligibility for this benefit and your benefit plan allowances.

What Does My Plan Cover?

All previously covered dental services are provided under the new Delta Dental DC 37 Health & Security Plan effective September 1, 2020. You can view a printable PDF of benefits below, review your coverage at www.deltadentalins.com or call (888) 523-DC37 (3237) to speak with a Delta Dental Customer Service Representative for any questions about your coverage. In all circumstances, the plan’s rules regarding restrictions, limitations, and annual dollar limits will apply.

• Summary of Changes to the Dental Benefit Effective September 1, 2020
• List of Covered Dental Services under the DC 37 Health & Security Plan
• List of Excluded Dental Services/Coverage Exclusions under the DC 37 Health & Security Plan
• List of New Dental Service Codes with Coinsurance

Annual Dental Benefit Maximum

$1,700 per calendar year per participant (including eligible spouses, domestic partners and dependents). In all cases should you obtain treatment that is restricted, has a frequency limitation, is a non-covered procedure or service or if you go over the yearly maximum, you will be responsible for any additional costs incurred.

Orthodontia Lifetime Benefit

$1,840 lifetime maximum benefit per eligible participant (including eligible dependents). The start date is the date the appliance is inserted. At the time the appliance is inserted the plan pays up to 50% of the lifetime maximum. At the start of the second year of treatment the plan pays the remaining 50% of the orthodontic lifetime maximum. This is a change effective September 1, 2020. The orthodontia benefit is not covered in the part time dental benefit and available only to dependent children for retirees.

When Is Predetermination for a Service Needed?

Predetermination is mandatory before beginning treatment for prosthetics (dentures and bridgework), single crowns, extensive gum treatment, TMJ therapy, root canal therapy, or orthodontics. YOU MUST SUBMIT A PREDETERMINATION PLAN FOR THE ABOVE LISTED SERVICES OR YOUR CLAIM WILL BE REJECTED.

How Do I File a Claim?

You only have to file a claim in the instance you receive a dental service from a non-participating, out-of-network dental provider. If using any Delta Dental network provider, the provider is responsible for filing all claims for you. You have no responsibility for filing dental claim forms.

If you use a non-participating dental provider, you will be responsible for filing your own dental claims with Delta Dental. You must file such claims within one year (365 days) from the completion of the dental service. A claim filed after 365 days from the date of service will be rejected for timely filing.

• Get Directions and Claim Form

How Do I Check a Claim Filed Prior to September 1, 2020?

Please contact the DC 37 Dental Unit at (212) 815-1600 for calls about dental claims that occurred before September 1, 2020.

Visit the DC 37 Dental Center

Eligible participants are welcome to make an appointment for treatment at our DC 37 Manhattan Dental Center. The same plan restrictions, limitations, and benefit maximums apply.

Please familiarize yourself with our required Dental Center Rules and Policies before making an appointment. All DC 37 Dental Center patients must agree to comply with patient policies.

Manhattan Center

115 Chambers Street
New York, New York 10007
Monday-Friday, 8am-6pm
Saturdays, 8am-5pm
(212) 815-1006
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