Across the United States, more than 40% of dentists participate in the Delta Dental PPO network and more than 70% of dentists participate in the Delta Dental Premier ® network. Delta Dental has the largest national network which means you'll find quality dental care wherever you are. Do keep in mind that in order to maximize your benefits. $528; 3330 Root Canal – Molar (excluding final restoration) $711; 4341 Periodontal Scaling and Root Planing (four or more teeth per quadrant) $167; 4910.

Individual Plan disclosures:

Clear Plan Insurance Policy from Delta Dental. A new way to do dental. And it starts here. A simple explanation of what your dental insurance will pay for. Dental benefits are important to you and those around you, so thank you for recognizing this and buying benefits from Delta Dental. Dental benefits are important, and so is this document. So, let’s take the jargon out of insurance and break down coinsurance vs. The percentage of costs of a covered health care service you pay after you’ve paid your deductible. Let’s say your dental insurance plan’s allowed amount for a crown is $100 and your coinsurance is 20%. While more than 3 out of 4 Americans have dental insurance 1, many don’t fully understand what dental insurance does and doesn’t cover.This quick guide to dental insurance can help you get a better understanding of how coverage usually works.

Delta Dental PPO plans are underwritten by Delta Dental Insurance Company in AL, DC (Policy- IENT-P-CORE-DC-REV2018), FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan.

DeltaCare USA plans are underwritten in these states by these entities: CA — Delta Dental of California; DC (Policy- I-P-DC-dc) and FL — Delta Dental Insurance Company; MD and TX — Alpha Dental Programs, Inc.; UT — Alpha Dental of Utah, Inc.; NY — Delta Dental of New York, Inc.; NV — Alpha Dental of Nevada, Inc.; PA — Delta Dental of Pennsylvania. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. These companies are financially responsible for their own products.

In Florida, Delta Dental Insurance Company provides DeltaCare USA Plan benefits as a Prepaid Limited Health Service Organization as described in Chapter 636 of the Florida Statutes.

Individual PPO plans have flexible enrollment. Here is an example of the effective dates based on plans: When does coverage become effective? DeltaCare® USA Plans purchased by the 21st of the month will become effective on the first date of the following month.

• E.g., a plan purchased on June 17 would become effective on July 1. Plans purchased after the 21st will not be effective until the month after that.
• E.g., a plan purchased on July 25 would not be effective until September 1. Delta Dental PPO™ plan purchasers have flexible enrollment options. Plans purchased from the first through the 14th of the month have effective date options of: the 15th of the current month, the first of the next month, the 15th of the next month or the first of the month after next.
• E.g., a plan purchased on July 3 can be effective July 15, August 1, August 15 or September 1. Plans purchased on or after the 15th of the month have effective date options of: the first of the next month, the 15th of the next month, the first of the month after next or the 15th of the month after next.
• E.g., a plan purchased on July 15 can be effective August 1.

Group Plan Disclosures:

Delta Dental PPO™ is underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan.

DeltaCare USA is underwritten in these states by these entities: AL — Alpha Dental of Alabama, Inc.; AZ — Alpha Dental of Arizona, Inc.; CA — Delta Dental of California; AR, CO, IA, MA, ME, MI, MN, NC, ND, NE, NH, OK, OR, RI, SC, SD, VA, VT, WA, WI, WY — Dentegra Insurance Company; AK, CT, DC, DE, FL, GA, KS, LA, MS, MT, TN, WV — Delta Dental Insurance Company; HI, ID, IL, IN, KY, MD, MO, NJ, OH, TX — Alpha Dental Programs, Inc.; NV — Alpha Dental of Nevada, Inc.; UT — Alpha Dental of Utah, Inc.; NM — Alpha Dental of New Mexico, Inc.; NY — Delta Dental of New York, Inc.; PA — Delta Dental of Pennsylvania. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. These companies are financially responsible for their own products.

1. Delta Dental Unique Dentists Penetration Report, 2019
2. Dental Actuarial Analytics, 2017 Dental PPO Study, includes all Delta Dental member companies
   
3. In some states, DeltaCare USA is offered as an open access plan where enrollees can obtain treatment from any licensed dentist; however, deductibles and maximums may be applied for services provided by an out-of-network dentist.
   
4. In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan.
   
5. In WY, you do not need to select a primary care dentist, but you must visit a network dentist to receive benefits. In the following states, you can maximize your savings when you visit a network dentist, although you may visit any licensed dentist and receive out-of-network coverage: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT. Refer to your plan booklet for details about your out-of-network benefits.
   
6. Limitations and exclusions apply. Refer to your plan booklet for more information about covered services, deductibles and maximums.

Delta Dental Insurance Copays

Already Enrolled?

Delta Dental Insurance Company Mi

Whether you have a Delta Dental Health Care Exchange (Marketplace) plan or you’re still considering one, you can find the answers to your most common questions here.

Delta Dental Copay Schedule

• How do I find the right dental insurance for me or my family?

  How do I get a Delta Dental Health Care Exchange (Marketplace) plan?

  To get stand-alone dental coverage for children, adults, or the entire family, visit healthcare.gov to explore Delta Dental’s ACA-compliant plans.

  What types of exchange plans does Delta Dental offer?

  Delta Dental offers ACA-compliant dental plans in 15 states, plus D.C., including pediatric-only plans and options for families.

  Plans on the Health Care Exchange (Marketplace) are categorized as high coverage and low coverage. A high coverage plan means you’ll pay a little more each month (in premiums), but you’ll owe the dentist less for covered services (and more may be covered!). With a low coverage plan, you’ll pay a little less each month (in premiums), but you’ll owe the dentist more for covered services.

  Beyond offering you high and low dental coverage options for children and families, you can also choose between a PPO and copay plan.

  
  

  Delta Dental PPO^TM1

  • Our coinsurance plan shares your costs for covered services.
  • After you meet your annual deductible, Delta Dental pays a percentage of your bill and you pay the rest.
  • You can visit any dentist, but you’ll save the most with a Delta Dental PPO dentist.
  • Children can use their benefits immediately — adults may have a waiting period for Major Services.

  DeltaCare^®USA¹

  • Our copay plan works like a dental HMO.
  • You must visit your selected DeltaCare USA dentist to receive benefits.
  • When you visit the dentist, just pay your predefined copayment and you’re all set.
  • You’ll know all copayments up front, so you can plan ahead for treatment costs.
  • Use your benefits right away — there’s no waiting period on children or adult services.

  When is open enrollment for individuals on the Health Care Exchange (Marketplace)?

  In most states, open enrollment for individual plans on the Health Care Exchange (Marketplace) starts on November 1 to obtain dental insurance for the new year. (For California residents, open enrollment starts on October 15.) Check healthcare.gov for exact open enrollment dates for your state.

  I already have Delta Dental coverage through my employer. What do I need to know?

  If you’re already a Delta Dental enrollee, you should be set with your current group coverage. For questions about your employer plan, reach out to your company’s benefits representative.

  I already have individual dental coverage. What do I need to know?

  If you already have individual dental coverage, you can keep your current coverage or you can explore our plans on healthcare.gov.

  If I purchase medical benefits through the Health Care Exchange (Marketplace), can I still purchase separate dental benefits?

  Yes.

  Do I have to have medical coverage if I want to buy a dental plan on the Health Care Exchange (Marketplace)?

  Yes. In order to purchase stand-alone dental coverage on the exchange, enrollees must have medical coverage.

• What do I need to know to start using my dental benefits?

  I signed up for a Delta Dental plan, but I haven’t received anything from you. How do I know if I’m enrolled?

  If you’ve recently enrolled in a Delta Dental plan on healthcare.gov or through your state’s Health Care Exchange (Marketplace), it may take up to 10 business days from the date you signed up for your enrollment to be processed. Once your enrollment is activated, you’ll receive a confirmation from us via email and/or postal mail. You can also check your enrollment status online at any time.

  What are Delta Dental’s Online Services? How do I sign up?

  With Online Services, you can find a network dentist, check benefits information (including eligibility and claims), make payments, view or print ID cards and get cost estimates for care. (Note that cost estimates are not provided for DeltaCare USA because copayments are provided up front.)

  Once you’ve received enrollment confirmation from us, simply sign up on our website. Select “Enrollee/Adult Dependent” from the initial drop-down menu and follow the prompts to create your account.

  How do I get an ID card?

  ID cards are not needed to use your benefits. You can simply give your dentist your name, date of birth and social security number or enrollee ID to verify coverage. If you prefer having an ID card in hand, you can print one by logging in to Online Services or you can display it from a mobile device.

  When can I start using my dental benefits?

  Once we’ve received your payment, and you have enrollment confirmation, you can start using your benefits on or after your effective date.

  How can I check my benefits and make payments? Can I do it online?

  The quickest way to check your benefits and make payments is online. Simply log in to your Online Services account from our website. You can also pay your invoice via check or by calling us at 888-857-0337.

• How do I find or switch my dentist?

  Can I keep my same dentist if I switch to a Delta Dental Health Care Exchange (Marketplace) plan?

  If your current dentist is in-network for the plan type you selected, then you’re good to keep that dentist. If your dentist is not in-network, here’s how it works:

  • With a Delta Dental PPO plan, you can visit any licensed dentist to receive benefits. However, you’ll usually save the most when you visit a PPO network dentist because these dentists accept reduced fees for plan enrollees.
  • If you have a DeltaCare USA plan, you must select a dentist in the DeltaCare USA network to receive benefits.

  How do I find a network dentist?

  To find a network dentist by location, just use our Find a Dentist tool.

  Select the network that corresponds to your plan and click search. For a more targeted search, you can enter the name of your dentist or dental office.

  Can I change my network dentist? How?

  Delta Dental PPO enrollees can change their dentist at any time — there’s no need to notify us.

  DeltaCare USA enrollees who want to select or change their primary care dentist should make the request via our online customer request form or by telephone at 888-857-0337. All DeltaCare USA dentist changes requested by the 21st of the month will take effect the first day of the following month.