Delta Dental of Michigan, Ohio and Indiana have amended their contracts effective 01/01/2017. The new contracts are mandating that dentists take action regarding the Medicare part D enrollment and complete training in order to continue participating as a Delta Dental network provider. CMS is requiring that dentists either enroll or opt out of the Medicare program in order for the patients they treat to be covered under Medicare Part D. However Dentists who opt out in Michigan, Ohio, and Indiana will no longer be eligible to participate as Delta network providers. This will be the case for any dentist who opts out after 06/20/2016. Providers who chose to opt out prior to 06/20/16 will be allowed to remain in the network until their renewal period up to two years later. During the renewal period if the decision is not made to terminate their opt-out status, these providers will also be terminated from the Delta Dental network. The decision to enroll or opt out is ultimately up to each individual dentist. However your options are very limited if you wish to remain a Delta Dental Participating provider. Below are some of the Advantages and Disadvantages of both listed by Delta Dental.
The full article posted by the ADA can be found here. http://www.ada.org/en/publications/ada-news/2016-archive/august/regional-delta-office-amends-dentists-contracts-to-address-medicare
Advantages of opting in:
- You’ll be listed in Delta Dental’s Medicare Advantage network directory.
- You’ll ensure payment as an in-network dentist for treatment you provide to Medicare Advantage patients with plans offered through the Delta Dental network.
- Your prescriptions for Medicare patients will be covered by the Medicare Advantage plan.
- You’ll remain in Delta Dental’s network (since several of their Medicare Advantage partners require them to terminate participation contracts of dentists who opt out or do nothing).
Dangers of opting out or doing nothing:
- By opting out, you’ll be excluded from participation in Delta Dental’s Medicare Advantage network for two years under present Medicare regulations.
- If you do nothing (neither opt in nor opt out), your Part D prescriptions will not be covered.
Below you will find a list of Medicare Advantage plans currently administered by Delta Dental. This list is expected to increase in 2017.
- Advantage by Superior HealthPlan
- Brand New Day
- Care1st Health Plan Partnership
- Central California Alliance for Health
- Central Health Medicare Plan
- Chinese Community Health Plan
- Cigna HealthSpring Medicare Advantage
- Coventry Health Care
- Geisinger Gold Medicare Advantage
- Health Care (PHC) Senior Advantage
- Health Plan of San Mateo-Care Advantage
- Health Sun
- HealthSpring of Alabama, Inc.
- Independent Health
- Inland Empire Health Plan-Medicare
- Kaiser Permanente Senior Advantage
- San Diego Neighborhood House Association
- San Mateo Senior Advantage
- Senior Care Action Network (SCAN)
- University HealthCare Advantage