1. Delta Dental Ppo Copay Card
2. Delta Dental Ppo Benefits

Cost Estimator terms of use

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Information regarding the Cost Estimator content

If you are experiencing a medical or dental emergency, you should seek appropriate emergency medical or dental assistance, such as calling '911.'
To begin using the Dental Care Cost Estimator tool, click the Agree button below. By clicking, you agree that you have read the information below, are accessing this information for purposes of determining treatment cost estimates for dental care services you are considering receiving, and will not use the information in this tool for a commercial or anti-competitive purpose. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Your actual cost may be higher or lower than the estimate for various reasons.

General information regarding your health care

The information and content (collectively, 'Content') on this website is for your general educational information only. The Content cannot, and is not intended to, replace the relationship that you have with your health care professionals. The Content on this website is not medical advice. You should always talk to your health care professionals for information concerning diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. Health information changes quickly. Therefore, it is always best to confirm information with your health care professionals.

The Dental Care Cost Estimator sometimes groups together, into 'treatment categories,' services that are often delivered together to address a particular dental problem. The description of different treatment categories, and the inclusion of particular services in a treatment category, is not advice that any particular treatment category is the right treatment for you or that you should not obtain any particular treatment. All of those matters are things that you should decide, in consultation with your dental care professionals. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. If you live outside the U.S., you may see information on this cost estimator about products or services that are not available or authorized in your country.

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. Benefits are paid only when members see a Delta Dental PPO or a Delta Dental Premier dentist. There are no benefits when a member sees a dentist outside of the Delta Dental network. Premium Plan: A plan with a $2,000 annual maximum, a $100 lifetime deductible, and great coverage on virtually every procedure you might need.

General information regarding your dental benefits

• Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. For a complete description of the details of your coverage, please refer to your coverage documents. Estimates may vary depending on your benefit plan and the state you live in. Claims will be processed when received according to your plan provisions.
• You may be responsible for the cost of procedures or services not covered by your plan.
• Use of this website in no way increases or decreases the benefits available under a dental benefit plan. If there is any conflict or discrepancy between the Content on this website and your coverage documents, your coverage documents will control.
• Pre-authorizations or referrals are required for certain benefit plans and certain dental care providers. Refer to your benefit plan to determine whether these requirements apply to you.
• Preventive services are included in this tool. Preventive care coverage varies by plan and by demographic considerations such as age. Refer to your benefit plan to determine whether preventive services are covered for you.

General information regarding cost estimates

• Do not avoid getting dental care based on the cost information provided on this website.
• This website shows estimates of certain dental care costs.
• The version of the Cost Estimator that is available publicly (does not require sign-in credentials) uses aggregated historical cost data for the procedure in question. The secure version (available only after you sign in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data.
• The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan.

More information regarding how cost estimates are calculated

Cost estimates for services provided by out-of-network dentists (available in the out-of-network estimator) are based upon submitted claims data for out-of-network providers. The data is based on actual, non-discounted charges that providers have billed.

Cost estimates are specific to geographic areas, as defined by the first three digits of a ZIP code (e.g., the geo ZIP for 12345 is 123).

Contact Delta Dental
Delta is here to help you with questions about your plan, coverage and for assistance finding a dental provider near you.

Delta Dental
DC 37 Customer Service Center
(888) 523-DC37 (3237)
Monday through Friday
8:00 am to 8:00 pm ET

Find a Dentist
www.deltadentalins.com
or call (888) 523-DC37 (3237)
Monday through Friday
8:00 am to 8:00 pm ET

All About Your Plan
www.deltadentalins.com
List of Covered Dental Services
List of Excluded Dental Services
How to File a Claim with Delta Dental
Frequently Asked Questions (FAQS)

Delta Account Sign-In
Create a Delta Dental account to review your full benefits package online, check the balance remaining on your annual dental maximum, print a copy of your ID card, and sign up for paperless statements.
www.deltadentalins.com

Brooklyn Center
186 Joralemon Street
Brooklyn, New York 11201
(718) 852-1400
View Map

Manhattan Center*
115 Chambers Street
New York, New York 10007
(212) 766-4440
*Manhattan Center is closed for renovations until Spring 2021.
View Map

Welcome to the New DC 37 Health & Security Dental Benefit

Administered by Delta Dental effective September 1, 2020

With DC 37’s new Delta Dental Plan you now have access to more participating dentists
than ever before. Eligible DC 37 New York participants will find over 1,800 “New York Select Network” dentists to choose from with $0 copays and eligible DC 37 members residing outside New York now have thousands more participating “PPO Network” dentists nationwide to choose from with $0 copays.

How to Get Started

Visit www.deltadentalins.com to see benefits and find a participating dental provider. You can also sign up for your personal Delta Dental account to review your full benefits package online, check how much of your annual maximum benefit is left, print a copy of your ID card, and sign up for paperless statements. Help is also available via phone from DC 37’s dedicated Delta Dental Customer Service Center at 1 (888) 523-DC37 (3237), Monday through Friday, 8:00 am–8:00 pm ET.

Your Delta Dental Group Number for DC 37 is 20970.

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.

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

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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.

Delta Dental Ppo Copay Card

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.

• 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

Delta Dental Ppo Benefits

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.

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 a DC 37 Dental Center

Eligible participants** are welcome to make an appointment for treatment at one of our DC 37 Dental Centers. 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.

Brooklyn Center

186 Joralemon Street
Brooklyn, New York 11201
(718) 852-1400
View Map

Manhattan Center*

115 Chambers Street
New York, New York 10007
(212) 766-4440
View Map

*Please note, the Manhattan Center is closed for renovations and scheduled to reopen in Spring 2021.

**Active and retired members covered by the DC 37 New York Public Library Health and Security Plan Trust and the DC 37 Cultural Institutions Health and Security Plan Trust are not eligible for dental services at the DC 37 Dental Centers.

DISTRICT COUNCIL 37 HEALTH & SECURITY PLAN DENTAL BENEFIT DISCLAIMER
PLAN COVERAGE FOR ANY WORK PERFORMED BY YOUR DENTIST ASSUMES THAT YOU ARE ELIGIBLE FOR BENEFITS WHEN THE WORK IS PERFORMED AND TAKES INTO CONSIDERATION THE PLAN’S RULES AND REGULATIONS REGARDING ELIGIBILITY, YEARLY MAXIMUMS AND FREQUENCY LIMITATIONS FOR CERTAIN PROCEDURES.

You have the right to opt-out of the Plan’s dental benefit coverage. Please call (212) 815-1620 for more information.