Medicare Part D and the Delta Dental Network

Recent contractual amendments made by Delta Dental of Michigan, Ohio and Indiana effective Jan. 1, 2017, state that dentists who chose to opt out of Medicare Part D in these three states will no longer be eligible to remain Delta Dental network providers. This amendment is specific to Michigan, Ohio and Indiana and will only impact dentists in those three states, despite recent statements by a company advertising to help dentists with Medicare provider enrollment.

Delta Dental of California verified that it is not adopting the same policy and is in the midst of building separate Medicare networks for its PPO and DeltaCare HMO products to ensure its Medicare enrollees receive coverage on Part D prescriptions and to reduce patient complaints.

All dentists are encouraged to evaluate whether Medicare participation is right for them and their patients by taking appropriate action to enroll as a Medicare provider, enroll as an ordering/referring provider or opt out of Medicare participation by utilizing the resources provided by CDA and ADA. The Centers for Medicare & Medicaid Services, administrator of the Medicare program, has urged providers to submit one of the enrollment or the opt-out forms four or five months in advance of the Feb. 1, 2017, compliance deadline.

For more information, see “Medicare Provider Options,” available at cda.org/resources.