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About the Program

The PHS ADDP is a federally funded dental program for the active duty officers of the Commissioned Corps of the U. S. Public Health Service. Commissioned Corps officers are highly trained public health professionals who work in one of several fields, including medicine, dentistry, pharmaceutical and veterinary medicine as well as environmental, dietary and therapy health services.


Eligibility

There are approximate 6,500 active duty officers in the PHS Commissioned Corps who stand ready to respond to public health and emergency needs around the globe. These Commissioned Corps officers are eligible for the PHS ADDP.


Service Area

Coverage under the PHS ADDP is offered worldwide, with the Delta Dental Premier Dentist network offered to those residing in the 50 United States, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. With worldwide coverage, enrollees in the PHS ADDP are able to enjoy access to their dental care regardless of where they live or travel.


Benefits and Coverage

Besides a broad scope of coverage that encompasses a wide range of the most commonly needed and used dental services, PHS ADDP enrollees have no waiting periods to satisfy, no deductibles to meet, and no annual maximum.

The PHS ADDP offers coverage for most diagnostic and preventive, simple and major restorative, periodontic and endodontic, oral surgery, prosthetic and emergency services. Covered services under these categories are paid by Delta Dental at 100%.

The PHS has determined what services are covered under the ADDP based on PHS policies and regulations. Delta Dental's Federal Government Programs division administers these benefits for the PHS ADDP. Dental services that are excluded from coverage under the PHS ADDP include orthodontics and/or orthognathic surgery, inlays and cosmetic dentistry, and services related to developmental growth deformities.


Submitting Claims

Delta Dental can accept and process PHS ADDP claims submitted in any legible format using the proper procedure codes in accordance with the most current version of the American Dental Association's Current Dental Terminology (CDT). Claims can be submitted electronically to Delta Dental as well as in hardcopy by U.S. mail. For your convenience, we have provided a standard claim form for you to complete for your PHS ADDP patients. You can register to use the Dental Office Toolkit to submit PHS ADDP claims electronically as well as track and monitor claims activity related to your PHS ADDP patients.

Overseas claims for the PHS ADDP are processed and paid according to Delta Dental's established policies. Overseas dental providers are not required to submit standard claim forms or utilize the ADA's CDT codes but should provide enrollees with a detailed receipt for services provided. Overseas claims for the PHS ADDP will be translated and cross-referenced to the appropriate corresponding ADA CDT codes by Delta Dental. Delta Dental will reimburse overseas enrollees in U.S. dollars using the exchange rate in effect on the date of service.

See "Contact Us" for the address of where to submit your PHS ADDP claims.

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