|Delta Dental PPOSM plus Premier||Our PPO plus Premier plan allows you to choose from more than 3,200 participating providers across the state. Participating providers file claims directly with Delta Dental and accept Delta Dental’s reimbursement in full. You are responsible only for your deductible and coinsurance (based on your plan), as well as any charges for non-covered services.||You may see any dentist; however, your out-of-pocket expenses will be less if you see a Delta Dental network dentist. The biggest discounts come from the 2,200 PPO dentists in our network.|
|Maximum Allowable Charge (MAC) a feature of Delta Dental PPOSM||We like to call this one the PPO Advantage! You have the option to see any provider, but all claims are paid according to the PPO fee schedule (maximum allowable charge), meaning you will pay more and run the risk of balance-billing when you select a non-PPO provider.||You may see any dentist; however, when you see a PPO provider, you are ensured the lowest out-of-pocket costs.|
|Exclusive Panel Option (EPO) a feature of Delta Dental PPOSM||Our EPO plan provides benefits only when members see a PPO provider. Treatment and services from a non-PPO provider are not covered.||Benefits are paid only when members see a Delta Dental PPO provider.|
|Delta Dental Patient Direct®||Patient Direct is not an insurance plan. It is a dental discount plan that provides members significant savings on certain dental procedures. With Patient Direct, you have no maximums, no waiting periods, no annual deductible, and no claims to file.
Click here to view the Delta Dental Patient Direct provider directory.
Click here to view the Patient Direct fee schedule.
|With Patient Direct, you must select a dentist from the 900-dentist Patient Direct provider network.|
|Enhanced Plan||A plan that closely mirrors an employer-sponsored dental plan. The Enhanced plan offers an ample benefit backed by the large provider network and outstanding service you expect from the state’s No. 1 dental carrier.||On this plan, you may visit any licensed dentist, but you will receive the greatest out-of-pocket savings if you see a Delta Dental PPO provider. If you choose to visit a Premier provider, you will still save money because Premier providers also accept discounted fees (however, discounts are not as great as if you see a PPO provider).|
|Classic Plan||An affordable plan with a traditional design. The Classic Plan covers most major procedures and is backed by Delta Dental’s large provider network and outstanding service.||On this plan, you may visit any licensed dentist, but you will receive the greatest out-of-pocket savings if you see a Delta Dental PPO provider. If you choose to visit a Premier provider, you will still save money because Premier providers also accept discounted fees (however, discounts are not as great as if you see a PPO provider).|
|Clear Plan||Dental insurance without a lot of dental-insurance jargon. The Clear Plan states in advance how much you’ll pay for dental work, and that’s exactly what you pay - nothing more! Additionally, this plan has no deductibles, no annual maximum, and no waiting periods.||Benefits are paid only when members see a Delta Dental PPO or a Delta Dental Premier dentist. There are no benefits when a member sees a dentist outside of the Delta Dental network.|
Right Start 4 Kids (RS4K)
Right Start 4 Kids is a unique plan design enhancement that removes most of the cost barriers to dental care by providing coverage for children up to their 13th birthday at 100% coinsurance for diagnostic and preventive, basic, and major services, with no deductible, when in-network providers are seen.* If an out-of-network provider is seen, the adult coinsurance levels will apply. Orthodontic services are available but are not eligible for the RS4K 100% coverage level. Read more to find additional details on Right Start 4 Kids.