DeltaCare USA DHMO
HMOs, or Health Maintenance Organizations, are copay based and cover services performed solely by providers within their network (with the exception of emergency services).
Deductibles & Copays:
- There is no deductible for this plan.
- Most services are covered at no cost (please review the Evidence of Coverage for details).
- Deductibles and copays are waived if accessing preventive care services.
How to Print a Temporary DeltaCare USA DHMO ID Card
- Visit Delta Dental's website at www.deltadentalins.com and login.
- If this is the first time logging in, you will need to register first.
- Once you have logged in, click the Eligibility & Benefits tab and select the "Print ID Card" option.
This plan uses a provider network. You may only access services from providers who are in the DeltaCare USA HMO network.
- You are required to select a primary care dentist. For a complete list of providers, please visit the Delta Dental website at www.deltadentalins.com. If you do not choose one at the time of enrollment, then one will be assigned to you, but you may change your primary care dentist by contacting DeltaCare USA's member services line at (800) 422 - 4234.
|Dental Plan Option Comparison Chart|
|Delta Dental DPPO||DetlaCare USA DHMO|
$50 Per Individual
|Maximum Benefits Allowed|| $2,500
Per Individual Per Year
|No Annual Maximum|
PPO Provider: 0%
|$0 for Most Services|
PPO Provider: 10%
| $0 for Most Services
A copay may be required for upgraded materials and services
| Major Services
(Including Periodontics, Endodontics, and Oral Surgery)
|50%|| $0 for Most Services
A copay may be required for upgraded materials and services.
|Orthodontia (Adult)||$1,880 Copay*||$1,900 Copay|
|Orthodontia (Child)||$1,660 Copay*||$1,700 Copay|
|*Once per lifetime With a maximum of 24 months of treatment.||Pre and post-treatment services have additional copayments.|
DeltaCare USA Member Services
(800) 422 - 4234
Human Resources - Employee Benefits Division
Phone: (559) 600 - 1810
Fax: (559) 455 - 4787
Address*: 2220 Tulare St., Suite 1400, Fresno, CA 93721
*Please note that Employee Benefits is not responsible for any lost or stolen mail, nor mail received after the deadline. All paperwork and supporting documentation must be received by the Employee Benefits office prior to any deadlines.