![[blank graphic]](../../images/blank.gif){kind=small}
NAVIGATION
Introduction | Welcome | Covered Services | Exclusions
Denver Public Schools
Employee Benefits Department
900 Grant Street, Room 502
Denver, Colorado 80203
(303) 764-3371
Dental Plan For Employees And Dependents
How To Use The Dental Care Plan
The patient may be treated by any licensed dentist. In the event the patient does not have a personal dentist, he/she may refer to the listing of Delta Dental Plan Participating Dentists. This listing is updated periodically by Delta.
During the first appointment the patient should inform the dentist that he/she is covered by the Denver Public Schools Delta Group No. 1015 and give the dentist the group name, group number, and the social security number of the employee covered. It is important that the dentist be told that Delta is providing the coverage, as most dentists will be familiar with the Delta dental care program and will have the necessary treatment forms in their office. The dentist should be asked to contact Delta if he/she does not have the treatment forms or desires additional information regarding the plan.
The dentist may examine, clean and x-ray the teeth, provide emergency treatment and render minor dental procedures without obtaining prior approval by Delta. The dentist will complete a treatment f + +Xm .. + +Qm FINDER DAT" + +Ym( a p p e a -l s . h t m l PPEAL~1HTM p|+ \$ n ESOURCEFRK + +\m t m l u a r b i t r a t i o n . h RBITR~1HTM q|+ \$ ~ h t m l st b e n e f ti t c h a r t . ENEFI~1HTM q|+ \$ 4& t m l b e n e f i t i n f o . h ENEFI~2HTM q|+ \$ q b e n e f 4i t s . h t m l ENEFI~3HTM r|+ \$ %P c o b . h ct m l OB~1 HTM r|+ \$ h t m l c o n t i an u a t i o n . ONTIN~1HTM s|+ \$ .! s . h t m 3l c o v e r i3a g e s t a r t OVERA~1HTM s|+ \$ } . h t m l c o v e r na g e s t o p s OVERA~2HTM s|+ \$ t m l T d e f i n i t i o n s . h EFINI~1HTM t|+ \$ e l i g i Ib l e . h t m l LIGIB~1HTM t|+ \$ l w e m e r g Gwe n c y . h t m MERGE~1HTM t|+ \$ ^, l M f i n a n Mc i a l . h t m INANC~1HTM t|+ \$ 7 i o n s . h t m l g e n e r e a l p r o v i s ENERA~1HTM u|+ \$ - l k h o s p i tkt a l s . h t m OSPIT~1HTM u|+ \$ h o w p l a n . h t m l OWPLA~1HTM u|+ \$ > h o w t o u s e . h t m l OWTOU~1HTM u|+ \$ m i m a g e oqs MAGES y|+ + i n d e x I3. h t m l NDEX~1 HTM v|+ \$ . m e d i c a r e . h t m l EDICA~1HTM v|+ \$ m l n o t c o v e r e d . h t OTCOV~1HTM v|+ \$ A h t m l p h o n e n u m b e r s . HONEN~1HTM w|+ \$ ) l X r e f e r r a l s . h t m EFERR~1HTM w|+ \$ appeals.htmlyR < xp y.TEXTMOSS uDD PPEAL~1HTMp arbitration.html< xp yTEXTMOSS uFD RBITR~1HTMp benefitchart.html< xp y TEXTMOSS uFD ENEFI~1HTMp benefitinfo.html y TEXTMOSS @ uFD ENEFI~2HTMp benefits.html y TEXTdosa @ uHD ENEFI~3HTMp cob.htmlsJ y xp y TEXTdosa @ uHD OB~1 HTMp continuation.html xp y TEXTdosa uJD ONTIN~1HTMp coveragestarts.htmlp y TEXTdosa uJD ~ OVERA~1HTMp coveragestops.htmlxp y TEXTdosa uJD } OVERA~2HTMp definitions.html xp y TEXTdosa uLD | EFINI~1HTMp eligible.html xp y TEXTdosa uLD { LIGIB~1HTMp emergency.html xp y TEXTdosa uLD z MERGE~1HTMp financial.html xp y TEXTdosa uLD y INANC~1HTMp generalprovisions.html y TEXTdosa uND x ENERA~1HTMp hospitals.html xp y TEXTdosa uND w OSPIT~1HTMp howplan.htmly xp y TEXTdosa @ uND v OWPLA~1HTMp howtouse.html xp y TEXTdosa @ uND u OWTOU~1HTMp images sJ V xp y @ uV^ t MAGES p index.html y xp yTEXTdosa @ uPD r NDEX~1 HTMp medicare.html xp y TEXTdosa uPD q EDICA~1HTMp notcovered.html xp y TEXTMOSS uPD p OTCOV~1HTMp phonenumbers.html xp y TEXTMOSS uRD o HONEN~1HTMpates Event Schedule bove two criteria and is justifiable considering the special circumstances of the particular case involved.
Benefit PercentagesCO-PAYMENT - Diagnostic and Preventive Delta will pay 100% of a Participating Dentist's usual, customary and reasonable fee.
CO-PAYMENT - Restorative Delta will pay 80% of a Participating Dentist's usual, customary and reasonable fee.
CO-PAYMENT - Major Services Delta will pay 50% of a Participating Dentist's usual, customary and reasonable fee for Oral Surgery, Endodontics, Periodontics, Cast Restorations and Prosthodontics. Benefits payable under this part of the Plan are subject to a $50 lifetime deductible, per eligible individual.
CO-PAYMENT - Orthodontic Services Delta will pay 50% of a Participating Dentist's usual, customary and reasonable fee.
Maximum Benefit
The benefits payable under the Plan will not exceed $1,000 per eligible individual during any one calendar year.
The benefits payable for Orthodontic Services are $1,000 per eligible individual during a lifetime.
NAVIGATION
Introduction | Welcome | Covered Services | Exclusions
Denver Public Schools
Employee Benefits Department
900 Grant Street, Room 502
Denver, Colorado 80203
(303) 764-3371