When you enroll in the UT Select Dental plan at the next open enrollment, you might have questions about choosing a dentist and how your dental plan works. Even if you already use Delta Dental benefits, did you know that this plan gives you the power to choose how you spend your dental benefits dollars? You can visit the dentist of your choice, but when you visit a Delta Dental DPO dentist, you will probably incur the smallest out-of-pocket expenses.
Delta Dental DPO dentists are reduced fee-for-service dentists. This means that they agree to accept a reduced fee as payment in full for their services. You also have a second option with Delta Dental Premier dentists, who agree to accept Delta Dental’s maximum allowed fee (which may be higher than the DPO amount) as payment in full. However, a non-Delta Dental dentist may bill you up to his or her submitted charge, and you would be responsible for any difference between the dentist's fee and Delta Dental's allowed fee (as well as any copayment, deductible and amount over the annual maximum). The chart below provides an example of how this might work based on the network participation of the dentist you select.
Sample claim only - actual amounts may vary. (Based on fee for Austin, TX, 78701)
Crown – Proc. #2790
DPO Dentist
Premier Dentist
Non-DPO/Premier
Dentist bills
$800
$800
$800
Dentist accepts $____ as payment in full (Delta Dental’s agreed-upon fee)