Smarter Plans

Dental plans are changing! Innovations in plan design that can save money for your clients and make their plans a better value for their employees.

CheckUp Plus™

CheckUp Plus™ is a new option for Delta Dental of Wisconsin groups that enables enrollees to obtain diagnostic and preventive dental services without those costs applying to their plan year individual annual maximum.

What services are included?

All services listed under the diagnostic and preventive services of your plan are included in CheckUp Plus.

  • Examinations
  • Routine x-rays and cleanings
  • Sealants (if they are part of your plan's diagnostic and preventive category)
  • Any other services that are in the diagnostic and preventive category

Example

The following example shows the impact of CheckUp Plus™ on an enrollee's individual annual maximum. (Plan benefit and dentist charges vary. Example assumes two routine check-ups, covered at 100%, and a $1,000 annual maximum.)

Two routine check-ups (Exams, x-rays, cleanings)
With CheckUp Plus™ Traditional Dental Plan
Delta Dental Pays Enrollee Pays Maximum Remaining Delta Dental Pays Enrollee Pays Maximum Remaining
$300 $0 $1,000 $300 $0 $700

Evidence-based Integrated Care Plan (EBICP)

Delta Dental of Wisconsin's Evidence-Based Integrated Care Plan (EBICP) provides expanded benefits for persons with diseases and medical conditions that have oral health implications. These benefits include increased frequency of cleanings and/or applications of topical fluoride. They address the unique oral health challenges faced by persons with these conditions, and can also play an important role in the management of an individual's medical condition.

  • High Risk Cardiac Conditions
  • Suppressed Immune Systems
  • Kidney Failure or Dialysis
  • Cancer Therapy
  • Periodontal Disease
  • Diabetes
  • Pregnancy

EBICP's unique enrollment mechanism requires no medical claims to be filed, and allows easy self-enrollment by the patient or his/her dentist.

Increased Sealant Coverage

  • Sealants have been shown to reduce the need for fillings by about 72%.
  • The average lifetime cost of a single cavity is more than $2,000 (fillings may need to be replaced, and sometimes ultimately result in the placement of a crown).
  • Delta Dental recommends covering sealants for primary or permanent molars for patients through 18 years of age, and carrying that coverage under the diagnostic and preventive category of the group's dental plan.

Reduced X-ray Frequency

  • Experts at the Food and Drug Administration and the American Dental Association recommend that patients at a low risk of chronic diseases such as cavities and periodontal disease receive less frequent exposure to dental x-rays.
  • Delta Dental recommends bitewing x-rays one time per 12-month period, and full-mouth x-rays once each 5 years for all patients.

Implant Coverage

  • Implants are now a standard part of coverage under new Delta Dental plans.
  • For groups that currently exclude implants, your contract or SPD can be easily modified to remove the exclusion.
  • Generally no cost impact - implant coverage provides employees with an additional, often-requested benefit, without impacting overall plan costs.

Composites vs. Amalgams

  • Resin-based composites (tooth-colored fillings) and amalgam (silver-colored fillings) are both used as options for restorations on posterior (back) teeth. Each has certain advantages. For example, composites can be more conservatively placed in small cavities, thereby causing less loss of tooth structure; while amalgam might provide the better choice in large, load bearing fillings or fillings below the gum line. Both materials are safe and effective. Composites are generally more expensive, and may result in higher out-of-pocket costs for the patient.
  • Delta Dental recommends coverage that gives dentists and their patients the ability to choose together whether amalgam or a resin-based composite is the appropriate restorative material.