Dental FAQs
Frequently Asked Questions
Listed below are some of the most commonly asked questions concerning dental benefits. They are listed in a question and answer format for easy reference. Please be advised these questions discuss some of the many dental benefits offered by the Michigan Conference of Teamsters Welfare Fund and do not necessarily describe your dental benefit plan. If you are unsure which dental benefits are available under your benefit plan, please contact our Member Services Call Center at (313) 964-2400 or (800) 572-7687 for benefit clarification.
MCTWF has contracted with Delta Dental of Michigan’s Premier and PPO networks, which are available nationwide. When verifying whether a dentist is in the network, always ask, “Are you a Delta Dental Premier or PPO dentist?”
You have three sources where you can check for this information:
- You can ask your current dentist if he or she in the Delta Dental Premier or PPO network; or
- You can check this website under Provider Networks; or
- You can contact our Member Services Call Center Monday through Friday, 8:30 a.m. to 5:45 p.m. Eastern Standard Time at (313) 964-2400 or toll-free at (800) 572-7687.
In general, MCTWF will pay your dentist according to the maximum allowable benefit (MAB) schedule amount, or your dentist’s charge, whichever is less. If your dentist’s charges are over the MAB amount, you will be responsible for the balance. In other words, you will be responsible for any difference between what the dentist bills and what MCTWF pays.
We believe that most participants will be able to access services using a Delta Dental Premier provider. At the same time, we have maintained a maximum allowable benefit schedule for out-of-network providers. Delta Dental Premier has a large number of network providers nationwide. However, in the event that you live further than 20 miles from any Delta Dental Premier dentist, or 25 miles from a Delta Dental Premier orthodontist, MCTWF’s Non-Access Benefit Exemption allows you to go to an out-of-network provider and enjoy in-network copayments and deductibles, however, you will still be responsible for any charges that exceed the maximum allowable amount. In order to receive this benefit, you must fill out an application (available on the “Forms” page on this site) which requires an approval. See your Summary Plan Description for a full explanation or contact our Member Services Call Center Monday through Friday, 8:30 a.m. to 5:45 p.m. Eastern Standard Time at (313) 964-2400 or toll-free at (800) 572-7687.
We believe that most participants will be able to access services using a Delta Dental Premier provider. At the same time, we have maintained a maximum allowable benefit schedule for out-of-network providers. Delta Dental Premier has a large number of network providers nationwide. However, in the event that you live further than 20 miles from any Delta Dental Premier dentist, or 25 miles from a Delta Dental Premier orthodontist, MCTWF’s Non-Access Benefit Exemption allows you to go to an out-of-network provider and enjoy network copayments and deductibles. However, you will still be responsible for any charges that exceed the MAB amount. In order to receive this benefit, you must fill out an application that requires approval. See your Summary Plan Description for a full explanation or contact the Member Services Call Center.
You have a choice. You can either use an in-network dentist or an out-of-network dentist. MCTWF can offer you benefits with less out-of-pocket expense when you use an in-network dentist because of fee arrangements whereby the dentist agrees to accept the contract fee as payment in full plus applicable deductibles and coinsurance amounts. We have no such agreement with out-of-network dentists. They have not agreed to any arrangement. They may charge whatever they want and may expect to receive total payments equal to their charge.
If your in-network dentist refers you to an out-of-network dentist, your claims will be paid according to the out-of-network schedule and you will be responsible for any balance due over and above the dentist’s charges. We encourage you to use dentists in the Delta Dental Premier or PPO Networks. The choice is yours. You may ask your dentist if he or she is in the Delta Dental Premier or PPO network, check the Delta Dental Premier or PPO Network directory on the “Provider Networks” page of this website or contact our Member Services Call Center Monday through Friday, 8:30 a.m. to 5:45 p.m. Eastern Standard Time at (313) 964-2400 or toll-free at (800) 572-7687. Referrals are not necessary, and benefits are paid according to the participating status of the dentist rendering the service.
No. Delta Dental is the dental network that has been contracted by MCTWF. Any questions related to claims should be directed to MCTWF by contacting our Member Services Call Center Monday through Friday, 8:30 a.m. to 5:45 p.m. Eastern Standard Time at (313) 964-2400 or toll-free at (800) 572-7687.
No. Delta Dental is the dental network that has been contracted by MCTWF. Any questions related to claims should be directed to MCTWF by contacting our Member Services Call Center Monday through Friday, 8:30 a.m. to 5:45 p.m. Eastern Standard Time at (313) 964-2400 or toll-free at (800) 572-7687.
For covered services provided by a nonparticipating dentist, Delta Dental will send reimbursement directly to you unless otherwise required by law or contract. You are responsible for any difference between Delta Dental’s payment and the dentist’s submitted amount. Reimbursement is in U.S. dollars using the exchange rate from the date of service to calculate the proper amount. Read more details HERE.