Understanding Your Benefits
Delta Dental offers plans that provide both choice and affordability. Under most plans, you can see any dentist and get coverage. But if you see a PPO dentist, you'll pay less for services. Contact Customer Relations at 1-800-610-0201 for a list of PPO dentists in your area.
Take a moment to find out what plan you're enrolled in. That will help you understand your benefits. Click here to access access Subscriber Connection to view your eligibility, claims and benefit information.
This section highlights the key things you need to know as a member, but is not specific to each group's coverage. For specific information on your dental coverage, please consult your Benefit Booklet.
For more information, please click on the links below:
How To Use Your Benefits
Eligible Dependents
Visiting the Dentist
Understanding the Delta Dental Networks
Meeting Our Customers' Needs
Pretreatment Estimate
Explanation of Benefits
Filing Claims
Common Terms
How to Use Your Benefits
You and your family members are covered for dental services when enrolled in one of Delta Dental plans. Depending on the benefit plan options your employer selected, you may be enrolled in a Delta Dental Premier, PPO, EPO, or Achieve Plan. With these plan types, you may be responsible for deductibles, coinsurance and copays. Please see your Benefit Booklet for what is covered under your plan.
Visiting the Dentist
With Delta Dental, visiting a dentist is easy. Once you've chosen a dentist, all you need to do is call to make an appointment. You don't need to inform Delta Dental in advance or ask for a referral to see a specialist. If you see a participating dentist:
- Your claim will be filed for you.
- You will not have to pay for services upfront.
- You will be responsible for any deductible or coinsurance at the time of service.
If you see a non-participating dentist, you may have to pay for services upfront. You also may need to submit your own claim to Delta Dental and wait for reimbursement.
Understanding the Delta Dental Networks
Delta Dental has two dental networks for its commercial insured products - Delta Dental Premier and Delta Dental PPO. Some dentists participate in one or both networks. The Delta Dental Premier network has more than 2,400 dentists in Colorado, while the PPO network has over 1,000 dentists. Your benefits often are based on the type of dentist you see. If you're enrolled in an EPO Plan, you must see a PPO dentist to receive benefits.
Meeting Our Customers' Needs
Delta Dental offers a variety of plan types to meet you and your employer's needs. Select the plan type that you are enrolled in for more information:
Delta Dental PPO Plan: Offers both choice and care at an affordable price when members use a PPO dentist. There are a variety of PPO options - the Maximum Allowable Charge (MAC) and the Exclusive Panel Option (EPO) plans.
The Delta Dental Premier Plan: a fee-for-service plan with a wide range of covered services.
Achieve Plan: an innovative new plan designed to maximize the potential for good long-term oral health outcomes.
Delta Dental Patient Direct:® discount plans (not insured products) that offered to employer groups as well as offered for individuals to purchase on their own.