How do I verify my eligibility and plan coverage?
To verify your eligibility and plan coverage, log in to your DeltaVision® account using your user name and password. You will need to create an account using your date of birth and member ID on your first visit. You or your eye health provider may also call the DeltaVision® customer service line at (877) 488-5130, and a representative will provide specific eligibility and plan information.
How can I reach customer service?
DeltaVision® customer service representatives are available Monday through Friday from 7 a.m. until 5 p.m. Central Time. You may reach them by phone at (877) 488-5130, or by email at email@example.com.
Will I receive an ID card?
Yes, DeltaVision® members will receive an ID card in the mail upon enrollment. If you have not yet received your ID card or you have lost your ID card, you may print a temporary ID card online. You will need to create a DeltaVision® account using your date of birth and member ID on your first visit.
Will I need my ID card for my appointments?
Members should present their ID card at the time of service to help expedite the process, but it is not required. If you do not have your ID card with you, just give the provider’s office your name, Social Security number and date of birth, and they will be able to determine your eligibility.
What if I lose my DeltaVision® ID card?
In the event of a lost or misplaced member ID card, please contact our customer service center at (877) 488-5130, email firstname.lastname@example.org, or print a temporary card online.
Does DeltaVision® use member Social Security numbers on the ID cards?
At Delta Dental, we take pride in safeguarding our members’ private information. Social Security numbers are kept in members’ secured files only, and are not displayed on identification cards. Each DeltaVision® benefit plan group is given a unique group number, and each member is given a unique ID number. Both numbers are displayed on the card.
What is my member identification number?
Your unique member ID number can be found on your DeltaVision® ID card.
Will I be required to pay a co-pay when I visit a provider?
Yes, you will need to pay a co-pay, a one-time payment for an eye exam or materials, when you visit a DeltaVision® network provider. To determine your co-pay amount, log in to your DeltaVision® account. You will need to create an account using your date of birth and member ID on your first visit.
Am I required to pay out of pocket for any materials?
You will be responsible for additional materials or services not covered within your benefits.
- Photochromic lenses – included in the DeltaVision® plans with a $60 co-pay
- Progressive lenses – included in the DeltaVision® plans with a $50 co-pay
- Tinting – $16 at participating discount providers
- Scratch coating – $16 at participating discount providers
- Polycarbonate lenses – covered in full for members under the age 19; available to members over the age of 19 with a $30 member cost at participating discount providers
What if I have an emergency, such as lost, stolen or broken glasses?
If an emergency arises, call customer service at (877) 488-5130 to verify eligibility and find a network provider. If you decide to visit an out-of-network provider, you will be reimbursed for the claim according to the DeltaVision® out-of-network schedule of allowances, provided you are eligible for the coverage.
Do I need a claim form if I see a network provider?
Claim forms are not required for services received from DeltaVision® network providers. Participating providers will file all in-network claims.
How does my claim get paid for an out-of-network visit?
Out-of-network providers require members to pay for their services. Members will need to submit a DeltaVision® Member Reimbursement Request Form with a copy of the original receipt to:
Advantica Claims Department
P.O. Box 8510
St. Louis, MO 63126-0510
Fax: (314) 849-4830 or (800) 501-8432
Out-of-network reimbursements are sent directly to DeltaVision® members within 30 days.
Can I choose contact lenses instead of eye glasses?
Yes, subject to plan frequency and co-pay, you can use your benefits to purchase contact lenses in lieu of eye glasses.
What types of lenses are covered? Are progressive lenses covered?
To further meet the needs of our members, DeltaVision® plans allow you to purchase the most popular lens options at controlled costs. We recommend that you discuss the benefits and cost differences with your eye doctor. DeltaVision® offers coverage for photochromic lenses and progressive lenses:
- Standard progressive lenses are covered at a $50 co-pay.
- Photochromic lenses are covered at a $60 co-pay.
Am I limited to a certain selection of frames?
If you do not find a frame that suits your preference, you may choose a frame outside of your special frame selection specified by the provider and pay the difference from your plan allowance. Please discuss the benefits and cost differences with your provider.
Is the DeltaVision® frequency limitation based on date of service or by calendar year?
Frequencies are based on the group’s contract period. For example, if a member of a group with a frequency limitation of 12 months and a contract year starting January 1, purchases a pair of frames on January 15, he or she will not be eligible for benefits for new frames until January 1 of the next year.
I am interested in LASIK. What coverage do I have?
Delta Dental has partnered with QualSight® to offer preferred pricing to DeltaVision members who are interested in laser vision correction. QualSight® has a proprietary network of independent, credentialed ophthalmologists at 800 locations nationwide. They also provide a toll-free telephone number, (877) 437-6108, which is specifically dedicated to DeltaVision® members. Different LASIK procedures are available because every patient is different. There is no charge to the member for the initial consultation appointment, and the QualSight® provider will advise the patient as to the best procedure that offers the best possible outcome, based upon their prescription and expectations. Out-of-network benefits are not available.
How do I get more information about LASIK and find out if I am eligible?
For information on LASIK benefits from DeltaVision® through QualSight®, click here. QualSight®, the nation’s largest LASIK program manager, offers a managed laser vision correction program through the National Networks of Credentialed Ophthalmologists.
If my vision is corrected through laser vision correction, will I be able to disenroll from DeltaVision®?
No. You must remain enrolled in the plan through your employer’s enrollment plan year, regardless of which covered vision benefits you use.
Does Delta Dental mail an explanation of payment after services are received?
Members who visited an out-of-network provider will receive an explanation of payment (EOP) along with their reimbursement check. The EOP also accompanies provider payments for in-network services. You may access a copy of the EOP by logging in to your DeltaVision® account.
How can I find a DeltaVision® provider?
Provider information is updated and made available to members via:
- Website. Members can use our online provider search engine to locate a provider. Members can find providers, based on distance from a city, state and ZIP with a search radius between five and 50 miles. The results can include a printable provider directory and driving directions with a map for easy reference.
- Email Inquiry Service. Members may email provider location requests to email@example.com. A customer service representative will respond (by telephone or email) within 24 hours of the inquiry.
- Customer Service/Operations Center. Members can call our toll-free telephone number, (877) 488-5130, Monday through Friday from 7:00 a.m. to 5:00 p.m. Central Time.
What if no network providers are available to me?
If you believe there are no network providers available in your area, please contact us for assistance. We may be able to help you find a network provider who is accessible to you. If no network providers are available, you will generally be able to visit an out-of-network provider and obtain reimbursement based on your plan if your plan includes this option. Please refer to the question above, “How does my claim get paid for an out-of-network visit?” for further information about obtaining reimbursement for out-of-network visits.
Are there optometrists and ophthalmologists in the DeltaVision® provider network?
Yes. The DeltaVision® provider network includes both optometrists and ophthalmologists.
Can I see one network provider for my exam and purchase my glasses through another network provider?
Yes, you may visit one network provider for services and another for materials. Network providers will verify eligibility and plan coverage to obtain authorization to provide services. Note: If you want to have your prescription filled by a network provider other than the one who performed the exam, please check with the provider first to ensure that the office will fill another doctor’s prescription.
My eye doctor is not in the DeltaVision® network. How can I request that he or she be added?
To refer an eye health provider to the DeltaVision® network, please complete the provider recruitment form and return it.
c/o Advantica Provider Recruitment
380 Park Place, Suite 150
Clearwater, FL 33759
(Please include all information requested on the form in your email)
What if I am dissatisfied with a network provider or the materials received through a network provider?
If you have a complaint, please contact customer service at (877) 488-5130. Representatives are available Monday through Friday from 7 a.m. until 5 p.m. Central Time.
Are out-of-network benefits offered with DeltaVision plans?
Yes, but out-of-network benefits are generally reimbursed lower than in-network benefits with DeltaVision®. You will also need to pay in advance and submit a DeltaVision® Member Reimbursement Request Form for payment after visiting an out-of-network provider. For specific details on your plan, log in to your DeltaVision® account. You will need to create an account using your date of birth and member ID on your first visit.
How is my DeltaVision® plan insured and administered?
DeltaVision® is underwritten by Advantica Insurance Company. DeltaVision® is administered by Delta Dental of Missouri and Advantica Administrative Services, Inc. (Advantica®).