What is the difference between a Delta dentist and a Delta Dental PPO dentist?

Three out of four dentists in the U.S. are Delta dentists. Delta dentists have an agreement with Delta, which means their fees are preapproved, they handle claims paperwork free of charge and they call Delta directly with any inquiries. Because Delta pays these dentists directly, you do not need to pay the entire bill and wait for reimbursement. Instead, you pay only the patient portion of the bill.

Delta Dental PPO dentists are a select group of Delta dentists who, in addition to the above conveniences, also charge lower fees. And, when you visit a PPO dentist, you maximize your benefits. There are approximately 74,000 PPO dental offices nationwide.

How do I maximize my benefits under the Delta Dental PPO program?

When you visit a PPO dentist, you receive the highest level of benefits with the lowest out-of-pocket expense. For example, diagnostic and preventive services such as a cleaning are covered at 100% when you visit a PPO dentist or at 80% when you visit a non-PPO dentist. Your deductible is also higher when you go to a non-PPO dentist: $75 per person versus $25 per person for a PPO dentist.

How do I find a Delta Dental PPO dentist?

Simply go to our online dentist directory to search for a conveniently located dentist near your home or office. You may also locate a specific dentist by entering his/her last name in the search form.

I'd like my dentist to join the Delta Dental PPO program. What do I do?

You can nominate your dentist for membership using our online form. Please note that nomination for PPO membership does not mean that a dentist automatically joins the network.

When dentists are nominated, Delta reviews each dentist's background. Then, we send the dentist a packet of information and an invitation to join the network. Ultimately, it is each dentist's decision whether or not to join based on a variety of factors, including accepting the more moderate fees paid under the program.

Do Delta’s plans have an annual maximum?

There is no annual maximum when using the DeltaCare^® USA program. With Delta Dental PPO, the maximum is $1,000 per person per calendar year.

How many teeth cleanings am I allowed per year?

DeltaCare USA offers three cleaning per calendar year. Delta Dental PPO offers two cleanings per year.

Do Delta’s plans cover mouthguards?

Yes, mouthguards are covered under both DeltaCare USA and Delta Dental PPO plans.

Do Delta’s plans cover tooth-colored (resin) fillings?

Resin fillings – including on the back teeth — are covered by DeltaCare USA. Coverage for resin fillings under the PPO plan is limited to certain teeth.

What benefits are offered to my dependents?

You do not need to do anything to continue your current benefit program.

Under the PPO program, your spouse and children have benefits.

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When can I change my dental program?

You can change your program during your regular LAUSD open enrollment period in the fall. Your enrollment change will be effective on January 1 of the following year. You'll have the opportunity to switch programs again at next year's open enrollment.

Can I change programs if I'm in the middle of orthodontic treatment?

If your child is currently undergoing orthodontic treatment and you are in the Delta Dental Premier program, you can still switch to Delta Dental PPO without any loss of benefits. And, if your dentist happens to be a PPO dentist, you may be eligible for an additional orthodontic benefit of up to $500 for work in progress. The actual payment will vary, based on such factors as the overall cost of treatment and the number of months you would continue to be in active treatment.

What if I have additional, specific questions?

You can contact Delta's Customer Service department at (866) 669-1755 or you can submit an inquiry online.