General Program Description
Delta
Dental Patient Direct is a dental program
that offers access to a network of Patient
Direct dentists who agree to provide dental
care at fees no higher than the Delta Dental
Patient Direct fee schedule. The fees listed
in the Patient Direct fee schedule reflect
a discount off of the average fees submitted
to Delta Dental of New Jersey by all of our
participating dentists in all of our networks.
Patient Direct is not insurance and members
are responsible for paying 100% of the Patient
Direct dentist's fee up to the Patient Direct
fee for the procedure. Most routine dental
services including braces and cosmetic services
such as bleaching are included in the program.
Members are also eligible for vision care savings.
Eligibility
If you do not have dental
insurance, are at least 18 years of age and a resident
of New Jersey, you are eligible to become a member
of Patient Direct. Patient Direct is not insurance
and does not coordinate benefits with insurance
carriers. Once you join and receive your membership
card, you can begin using your membership immediately.
You will be able to access your membership information
online the first of the following month. Notification
will be through a welcome packet and receipt of
ID card(s).
Program Cost
Membership runs for one year
after enrollment. The annual enrollment fee for
individuals is $66.00, or $96.00 for a family.
Family membership includes spouses, including domestic
partners (must be able to furnish a certificate
of civil union if requested by Delta Dental), all
children until the end of the membership year in
which they turn 23 years of age, and any disabled
child who is fully dependent on you for support.
Family members who have dental insurance are not
eligible for Patient Direct.
If, for any reason, you are
not satisfied, you may notify Delta Dental in writing
within 30 business days of the effective date of
your membership, and Delta Dental will fully refund
your money.
Included Services
Delta Dental Patient Direct
includes general services such as routine cleanings,
fillings, and x-rays, as well as crowns, root canals,
gum treatments, extractions, dentures, orthodontia,
and cosmetic services. Because this is not dental
insurance, even treatment for pre-existing dental
conditions is subject to the fee schedule. If you
require specialty care, simply visit one of the
participating specialists. Note that the fees
for services rendered by general dentists are generally
lower than fees of specialists.
Delta Dental Patient Direct
is not insurance; therefore, there are no deductibles,
no claims to file, no frequency limitations, and
no waiting
periods. This program does not apply to any
dental services which have begun prior to the date
you joined Patient Direct. If a dentist has given
you a treatment plan before you joined Patient
Direct, you will need to notify the dentist that
you have joined Patient Direct before you begin
treatment.
The Delta Dental Patient Direct
fee schedule is based on a reduction of the average
fees submitted to Delta Dental of New Jersey by
New Jersey participating dentists. Since individual
dentists' usual fees vary from office to office,
the cost savings can vary as well. Cost savings
in the following example range from 35% to 50%.
Delta Dental
Patient Direct Potential Savings
| Procedure |
Average
Fee* |
|
2010
Patient Direct
Fee Schedule |
|
Potential
Cost
Savings |
| Periodic
Evaluation |
$51.00 |
|
$32.00 |
|
$19.00 |
| Comprehensive
Exam |
$80.00 |
|
$38.00 |
|
$42.00 |
| Full
Mouth X-rays |
$127.00 |
|
$78.00 |
|
$49.00 |
| Periapical
X-ray |
$24.00 |
|
$15.00 |
|
$9.00 |
| Bitewing
X-rays - 2 |
$40.00 |
|
$23.00 |
|
$17.00 |
*Average
Fee is based upon the submitted fees of all of
Delta Dental's participating dentists in all
of its networks.
Dental Network
You must be treated by
a dentist in the Patient Direct network to receive
services at fees below or at the amounts listed
in the Patient Direct fee schedule. If you
visit a dentist who is not a participating Delta
Dental Patient Direct dentist, you may not receive
services at the Patient Direct fee schedule and
are required to pay the dentist fees in full. Participating
dentists have agreed to charge no more than the
fees listed in our Patient Direct fee schedule
(which are discounted from average fees submitted
to Delta Dental of New Jersey by its participating
dentists).
To find out if your dentist
is a Delta Dental Patient Direct dentist, or to locate a participating
Delta Dental Patient Direct dentist, search
our online dentist directory. Simply present your
ID card to any Patient Direct participating dentist
in our New Jersey statewide network, and he or
she will not charge you more than the fees listed
in our Patient Direct fee schedule. You must pay
the dentist at the time of service.
Vision Care Savings
Delta Dental Patient Direct
membership also includes savings on eye exams,
frames, lenses and contact lenses through EyeMed
Vision Care. Visit www.eyemedvisioncare.com/deltadental for
more information.
Join Now
You can join three ways:
You may pay your annual fee
with major credit cards, or if mailing a paper application,
via personal check. Once you've registered and your
payment has been confirmed, we will mail your membership
packet within 7 to 10 days.
If you have any additional
questions, please refer to our FAQs or
call 877-TOOTH-07 (877-866-8407).
Delta Dental
Patient Direct is not an insurance product.
