Summacare Dental Insurance! Trivia Questions Quiz

A member enrolled in a SummaCare Medicare Advantage Individual plan is eligible to purchase the optional supplemental dental benefit through Delta Dental. This means that if someone has a SummaCare Medicare Advantage Individual plan, they have the option to add on a dental benefit through Delta Dental. This additional dental coverage is not automatically included in the plan and must be purchased separately.

The given statement is true because it states that there is only one Delta Dental plan option available to SummaCare Medicare Advantage members. This means that these members do not have multiple options to choose from when it comes to Delta Dental plans.

The statement is stating that the Delta Dental monthly plan premium of $25 is an additional cost that needs to be paid on top of the SummaCare Medicare Advantage member's medical premium if they apply. This means that if someone wants to have the Delta Dental monthly plan, they will need to pay an extra $25 per month in addition to their regular medical premium. Therefore, the statement is true.

Delta Dental enrollment is available for a period of 30 days starting from the effective date of the new enrollee. This means that individuals who are eligible to enroll in Delta Dental can do so within this 30-day window. After this period, the opportunity to enroll may no longer be available. Therefore, the statement is true.

The correct answer is $25. This is the monthly premium for the Delta Dental plan. It means that in order to have this dental insurance, the individual would need to pay $25 per month.

The Delta Dental plan is a PPO plan. PPO stands for Preferred Provider Organization. In a PPO plan, members have the freedom to choose their dental care providers, whether they are in-network or out-of-network. However, members usually receive greater benefits and lower out-of-pocket costs when they visit dentists within the PPO network. PPO plans also do not require referrals for specialists.

The statement is stating that there is no deductible under the Delta Dental plan. This means that individuals who have this plan do not have to pay any out-of-pocket expenses before their dental coverage kicks in. Therefore, the correct answer is true, indicating that there is indeed no deductible under the Delta Dental plan.

When a member receives services from a non-participating dentist, it means that the dentist is not part of the insurance network. As a result, the insurance plan may not cover the full cost of the services provided, leading to higher out-of-pocket expenses for the member. This is because non-participating dentists may charge higher fees or not adhere to the insurance plan's negotiated rates. Therefore, it is true that services rendered by a non-participating dentist will usually result in more out-of-pocket costs for the member.

Under the Delta Dental plan, if a member chooses to see a dentist who is not part of the network or is a non-participating dentist, they may be balanced billed. This means that the dentist may charge the member for the difference between their usual fee and the amount covered by the Delta Dental plan. Therefore, the statement "a member may be balanced billed when seeing a non-participating dentist" is true.

The explanation for the correct answer, which is True, is that Delta Dental has a maximum payment limit of $1,000 per member per benefit year for all services covered under the plan. This means that regardless of the type of service, the maximum amount that Delta Dental will pay for any individual member in a year is $1,000.