Vision and Dental

Vision Plan Summary

Your vision plan benefits include a benefit for elective refractive corrective surgery, not the result of cataracts (e.g. LASIK Surgery). There are two very important conditions with this change. First, there is a lifetime maximum benefit of $2,400. Second, when you use this benefit, it is in lieu of any future hardware benefit (frames, lenses, contacts) under the Plan. You would remain eligible for an annual eye exam, however, you will no longer be eligible to receive benefits for lenses, frames, or contacts. Please contact the Trust office for full details on how to use this benefit.

Vision Exam – Covered in full
Vision Hardware – 100% up to $600 every two calendar years
Corrective Elective Refractive Surgery (non-cataract) – Up to a $2,400 lifetime allowance for elective refractive surgery, in lieu of any future benefits for hardware (frames, lenses, or contacts)

Delta Dental is your plan’s dental provider

The Delta Dental website is simple to navigate with helpful tools, such as a cost estimator. Login to your account to find a dentist, view and download your explanation of benefits, pay your bill, or see what is covered by your plan. You and your dependents each have your own page within your online account, which makes it easy to view everyone’s benefits and care history all in one place.

Go to Delta Dental

Current Dental Plan

There are no changes to the Delta Dental Plan for this year.

You (and any family members you’ve elected to receive medical coverage) will automatically be enrolled in the Delta Dental PPO dental plan.
Delta offers the broadest PPO network with the best provider discounts through the national Delta Dental Network.

This benefit comparison is only a summary of the benefits and not intended to replace the specifics of the Plan Contract. If there is a discrepancy, the Plan Contract will supersede this summary.

*Out-of-pocket costs will always be less when you see a Delta Dental PPO dentist. Delta Dental PPO and Premier dentists have negotiated contracts and cannot charge you more than the allowable amount. Non-Participating dentists may “balance bill” you for amounts in excess of what Washington Dental Service / Delta Dental allows.

How do I register for an account at Delta Dental?

It’s easy. Go to www.deltadentalwa.com, click on ‘Register’ at the top and follow the prompts. Once you’ve registered, you’ll have access to your benefits and eligibility information and claims status for yourself and, in most cases, any dependents on your plan

How do I check to see if I have met my deductible and/or what is remaining on my annual maximum?

Sign in to your member account to access information about your plan. If you don’t have an account, go to www.deltadentalwa.com to set one up.

How do I find a participating dentist in my area?

Under your plan, you can choose dentists from two networks: Delta Dental PPO™ or Delta Dental Premier®. You can find a participating, in-network, dentist in your area by visiting www.deltadentalwa.com and using our Find a Dentist tool. We recommend you select the Delta Dental PPO network to filter your search results.

What are the advantages of visiting an in-network dentist?

We encourage you to see a Delta Dental network dentist because they provide services at discounted rates and file all claims paperwork for you. We will pay our portion and you’re only responsible for your stated deductibles, coinsurance and/or amounts in excess of the plan maximums. In most cases, you will experience the greatest out-of pocket savings if you choose a dentist from the Delta Dental PPO network.

What information do I provide when I visit participating, in network dentist?

Be sure to tell your dentist you’re covered by Delta Dental of Washington and give them your member identification number, plan name and group number. You can find all this information by logging in to your account at www.deltadentalwa.com.

What if I want to continue with my own dentist, but they are not in the Delta Dental network?

You are not limited to using a Delta Dental network dentist. You may use any licensed dentist. If you choose a non-participating dentist, you will be responsible to have the dentist complete your claim forms and to ensure that the claims are sent to us. Claim payments will be based on actual charges or our maximum allowable fees for non-participating dentists, whichever is less. You’re then responsible for any balance remaining after we pay. Unlike our participating dentists, we have no control over non-participating dentists’ charges or billing procedures.

What happens when my dentist refers me to a specialist?

If you are considering extensive treatments such as crowns, oral surgery, periodontics or prosthodontics, we recommend you ask your dentist to request a predetermination from Delta Dental. They will process the request and provide you and your dentist with a Confirmation of Treatment and Cost (Confirmation). The Confirmation will show you what procedures will be covered, an estimate of what Delta Dental of Washington will pay and your expected financial responsibility. Confirmations are based on the treatment plan submitted by your dentist and the covered dental benefits available to you at the time the Confirmation is issued. Confirmations are estimates, not guarantees of payment.

Can I receive dental treatment when I am out of the country?

Delta Dental’s networks are nationwide and most dental plans allow you to visit a dentist anywhere within the 50 states, Washington, D.C. and Puerto Rico and receive the same benefits you would receive at home. Yes, you can receive dental treatment when you are out of the country. Simply submit an out of country claim form available at www.deltadentalwa.com.

Does Delta Dental require claim forms? Where should claims be sent?

Most dentists will submit claim forms on your behalf. If you do need to submit a claim yourself, we have forms available for download. Sign in to your member account to access claim forms.