There are two Delta Dental networks available to State of Texas Dental Choice participants:
- Delta Dental PPOTM network
- Delta Dental Premier® network
Both networks offer dentists credentialed to the same high quality standards. The difference between the networks is how much you pay. If you choose a Delta Dental PPO dentist, you will likely pay less out-of-pocket. If you choose a Delta Dental Premier dentist, you will still receive coverage, but will likely pay more for services.
You will pay a deductible and coinsurance.
The plan is available to Texas Employees Group Benefits Program (GBP) eligible employees, retirees and dependents. Evidence of Insurability is never required to enroll in this plan.
- You and your dependents must enroll in the same dental plan.
- You can enroll in this plan during your first 31 days of employment. There is no waiting period.
- You can also enroll when you have a qualifying life event (QLE), such as a birth or marriage, and coverage will begin on the date of birth or the first of the month following the event.
Preventive services are covered including two routine exams and cleanings per calendar year. You will pay a deductible and coinsurance for basic and major services. Adult and child orthodontic services are available. Costs vary depending on whether you use a network or an out-of-network dentist and the type of services provided. The plan pays up to $2,000 for covered services each year. Once the calendar year maximum is reached, the plan pays 40% of covered services for in-network dentists only.
Want more information about this plan? Review the following for details.
- State of Texas Dental Choice PPO Benefits Fact Sheet (PDF, 580 KB)
- State of Texas Dental Choice PPO Member Handbook (PDF, 682 KB)
If you use a network dentist, preventive care — like routine cleanings and exams — is covered at no cost to you. After your deductible, you pay a percentage of the billed charges for non-preventive treatment. Covered services under the PPO plan are paid based on a percentage of the dentist’s fee. For example, if a crown is covered at 50%, you pay the remaining 50% of the cost. (You may be responsible for a deductible, as well as charges for non-covered services and amounts over the annual maximum.)
This plan has two networks you can access for reduced dentist fees. You’ll usually pay lower out-of-pocket costs when you choose a dentist from the PPO network. Visiting a Premier dentist offers the next best opportunity to save on out-of-pocket costs, but you typically won’t save as much with a Premier dentist as you would with a PPO dentist.
Networks explained — Maximize Your Savings (PDF, 373 KB)
Please see your Master Benefit Plan Document (MBPD) (PDF, 319 KB) for a complete description of plan benefits, limitations and exclusions.
Get answers to common questions about the PPO plan.
Delta Dental dentists will handle all claims and paperwork for you. However, if you visit a non-Delta Dental dentist, you may need to file the claim yourself. Learn how to file a PPO claim.
1 The State of Texas Dental Choice Plan is offered by Employees Retirement System of Texas and administered by Delta Dental Insurance Company.