Delta Dental Premier and Delta Dental PPO Compare

Current Location: Stanford University home page > Comparison of Delta Dental Premier and Delta Dental PPO

Comparison of Delta Dental Premier and Delta Dental PPO

	Delta Dental Premier	Delta Dental PPO
		In-Network Delta Dental PPO dentists (1)	Out-of-Network (non-Delta Dental PPO dentists)
Who's Covered	Primary enrollee, spouse and eligible children.
Deductible (per person annually)	$50	$0	$50
Family Deductible (annually)	$150	$0	$150
Maximum (annually)	$1,000	$2,000	$1,500
Diagnostic and Preventive (no deductible)	100% of Delta Dental's allowed fee	100% of Delta Dental PPO fee	80% of Delta Dental's allowed fee (2)
Basic Benefits: (extractions, root canals, periodontic treatment, sealants)	80% of Delta Dental's allowed fee	80% of Delta Dental PPO fee	60% of Delta Dental's allowed fee
Crowns and Restorations	50% of Delta Dental's allowed fee	50% of Delta Dental PPO fee	50% of Delta Dental's allowed fee
Prosthodontic bridges, dentures	50% of Delta Dental's allowed fee	50% of Delta Dental PPO fee	50% of Delta Dental's allowed fee
Orthodontic	Not covered	50% of Delta Dental PPO fee	50% of Delta Dental's allowed fee
Orthodontic Maximum	Not covered	$1,500 lifetime maximum per adult $1,500 per child	$1,500 lifetime maximum per adult $1,500 per child

Notes:
(1) * In California, Delta endodontists, oral surgeons and periodontists are not DPO dentists, but you receive in-network benefits when visiting one of these specialists. You must visit a DPO prosthodontist or DPO orthodontist in order to receive the maximum in-network benefits under the program.

(2) When visiting a non-DPO dentist, you pay the difference between the dentist's fee and Delta's allowed fee plus the copayment.