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Provider Manual

Dental services

Last Updated on October 15, 2020

Delta Dental preventive and supplemental benefits

  • Security Health Plan has partnered with Delta Dental to provide preventive and supplemental dental benefits.
  • Each calendar year all Medicare Advantage members except Secure Saver MSA are offered a preventive dental exam covered at 100% by Security Health Plan. This exam must be performed by a Delta Dental Medicare Advantage network dentist.
    • Ally Rx D-SNP members may have additional dental coverage through their Wisconsin Medicaid benefits
  • All Medicare Advantage HMO-POS members can purchase a supplemental dental benefit.
  • Ally Rx D-SNP members can purchase a supplemental dental benefit starting 01/01/2021.
  • Secure Saver MSA members do not have coverage for supplemental dental services.
  • All HMO-POS and D-SNP members receive a Delta Dental ID card for either Preventive or Enhanced coverage
  • Questions about benefits, limitations, covered services, provider network or claims should be directed to Delta Dental Customer Service at 1-866-548-0292.
    • Hours are Monday – Friday 8 AM to 8 PM CST
  • Claims should be submitted directly to Delta Dental

Dental services covered under the medical benefit

  • Security Health Plan Medicare Advantage plans, including Ally Rx D-SNP and Secure Saver MSA, follow Medicare guidelines on coverage for dental services covered under the medical benefit.
  • For information on dental services that Medicare covers see the CMS.gov website.
  • Medicare covered dental services must be completed by a Medicare certified provider to qualify for coverage.
  • Claims for dental services covered under the medical benefit must be submitted on a CMS 1500 claim form. Claims submitted on a dental claim form will be denied.