In cases where alternate or optional methods of treatment exist, Delta Dental will pay for the least costly professionally accepted treatment. This determination is not intended to reflect negatively on the dentist’s treatment plan or to recommend which treatment should be provided. It is a determination of benefits under the terms of the subscriber’s coverage. The dentist and subscriber or dependent should decide the course of treatment.

If the treatment rendered is other than the covered benefit, the difference between the Delta Dental allowance and the dentist’s fee, up to the approved amount, for the actual treatment rendered is due from the subscriber.

For example, if your benefit plan allows for amalgams only even though a metal or porcelain inlay is suggested by your dentist, Delta Dental will pay for only the cost of the amalgam.