What are the differences between the Delta Dental Premier and Delta Dental PPO programs?
Delta Dental Premier is a managed fee-for-service program, while Delta Dental PPO is a preferred provider organization (PPO) program. The programs are similar in that they allow you to choose any dentist and to change dentists at any time without notifying us. You and your family members can also visit different dentists under the two programs.
*There are some limitations to implant benefits, so please check your Evidence of Coverage before obtaining these services.
There are several ways your out-of-pocket costs will be less under the Delta Dental PPO program:
- Delta Dental PPO dentists generally charge lower fees.
- Additional benefits are available (orthodontic procedures).
- Delta Dental PPO has higher annual maximum benefit.
How can I decide which program would work better for my family? After reviewing your benefits under each program and comparing them to your family's treatment needs, consider what dentist(s) you would visit. To see if your current dentist is a Delta Dental PPO dentist or to find one in your area, go to our dentist directory. Our online directory also provides a map to each office (simply click on the office's street address).
If I don't select a Delta Dental PPO dentist, should I still consider enrolling in Delta Dental PPO?
It may still be advantageous for you to enroll in Delta Dental PPO, depending on what type of dental services you usually use, because you have a higher annual maximum benefit. Remember, if you go to a non-Delta Dental PPO dentist, you receive the lower level of benefits.
What is the difference between a Delta dentist and a Delta Dental PPO dentist?
Four out of five 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 Delta Dental PPO dentist, you maximize your benefits. There are more than 116,500 Delta Dental PPO dental offices around the U.S.
How do I maximize my benefits under the Delta Dental PPO program?
When you visit a Delta Dental 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 Delta Dental PPO dentist or at 80% when you visit a non-Delta Dental PPO dentist. Your deductible is also higher when you go to a non-Delta Dental PPO dentist: $50 per person versus no deductible for a Delta Dental 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 Delta Dental PPO. What do I do?
You can nominate your dentist for membership using our online form. Please note that nomination for Delta Dental 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. If you decide to join the Delta Dental PPO program, do not assume that your dentist will be enrolling and be prepared to switch dentists.
When can I change my dental program?
You can change your program during your regular 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.
What if I have additional, specific questions?
You can contact Delta's Customer Service department at 800-765-6003 or you can submit an inquiry online.
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