Choose a Dentist
Under the AARP® Dental Insurance Plan administered by Delta Dental Insurance Company, you're free to choose any dentist you want, or stick with the one you already have. However, by selecting a Delta Dental PPOSM dentist or a Delta Dental Premier® (Premier) dentist, you may reduce your out-of-pocket costs.
The following chart helps explain the difference in costs based on the dentist you choose.
| Delta Dental PPO Dentists | Delta Dental Premier (Premier) Dentists | Non-Delta Dental Dentists | |
|---|---|---|---|
| Overview | Provide greatest ability to limit your out-of-pocket costs | May charge a somewhat higher fee than PPO dentists | Have no fee limits and may charge full cost of treatment |
| Dentist's Fees | Provide treatment at moderate fees; accept the Delta Dental PPO Maximum Plan Allowance as payment in full* | Provide treatment at reduced, pre-negotiated fees; accept the Premier Maximum Plan Allowance as payment in full* | Do not accept set or pre-negotiated fees; may charge full cost of treatment |
| Member Payment** | Deductible + Copayment/Coinsurance |
Deductible + Copayment/Coinsurance + Difference between the Delta Dental PPO Maximum Plan Allowance* and the Premier Maximum Plan Allowance* |
Deductible + Copayment/Coinsurance + Difference between the Delta Dental PPO Maximum Plan Allowance* and the dentist’s full fee |
| Claim Process | Delta Dental PPO dentists handle all claims and bill Delta Dental directly Member receives notice explaining the portion of the bill Delta Dental and the member are responsible for paying |
Premier dentists handle all claims and bill Delta Dental directly Member receives notice explaining the portion of the bill Delta Dental and the member are responsible for paying |
Non-Delta Dental dentists may or may not handle claims paperwork Member may have to pay up front, then submit claim to Delta Dental to be reimbursed |
* Delta Dental PPO Maximum Plan Allowance and Premier Maximum Plan Allowance may vary by dental office and/or dental specialty.
** Member is responsible for any amount over the plan calendar year maximum benefit and any non-covered service.
† The PPO network is not available in Alaska, South Dakota or Wyoming. In North Carolina and Texas, the PPO network is referred to as DPO.
In Massachusetts, there are no Delta Dental PPO dentists located in Dukes or Nantucket counties. Enrollees whose primary residences are located in Dukes or Nantucket counties may receive covered services from any dentist located in those counties. Enrollees’ out-of-pocket costs for covered services will be calculated based upon the PPO Maximum Plan Allowance as though such care is provided by a Delta Dental PPO dentist, so that they will receive the cost-limiting advantages available from Delta Dental PPO dentists.
In all counties in Massachusetts, covered services may be obtained from any specialist, whether a Delta Dental PPO dentist or other dentist. Enrollees’ out-of-pocket costs for services from all specialists will be calculated based on the PPO Maximum Plan Allowance as though such care is provided by a Delta Dental PPO specialist, so that they will receive the cost-limiting advantages available from Delta Dental PPO dentists.
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