Delta Dental

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Sample of Delta Dental PPO* benefits

Most patients have a financial incentive to seek care from an in-network dentist. Here is a sample of benefits paid under a typical Delta Dental PPO program (programs will vary).

*In Texas, Delta Dental offers dental provider organization (DPO) programs.

Type of service	Delta Dental PPO dentist	Out-of-network dentist
Diagnostic & preventive	100% of Delta Dental PPO approved fee*	80% of Delta Dental approved fee.**
Basic services	80% of Delta Dental PPO approved fee*	50% of Delta Dental approved fee.**
Crowns & cast restorations	50% of Delta Dental PPO approved fee*	50% of Delta Dental approved fee.*
Prosthodontics	50% of Delta Dental PPO approved fee*	50% of Delta Dental approved fee.**
Annual Deductible	$25 per person $75 per family	$50 per person $150 per family
Deductible for diagnostic & preventive	No	Yes
Annual maximum	$1,500 per person	$1,000 per person

**Delta Dental approved fee is either your Delta Dental Allowance or the Delta Dental PPO approved fee.