Dental
Plan/Group Number 05479
(888) 335-8227
What You Need To Know
Keep your smile looking its brightest with the help of dental coverage provided through the Delta Dental Preferred Option (PPO) Plan. Our Plan allows you to see any licensed dentist, but the Plan pays increased benefits when you use a Delta Dental PPO dentist.
Highlights
Under the Delta Dental Plan, you can use any licensed dentist, but your out-of-pocket costs will be lower when you use Premier dentists and will be the lowest when you use PPO dentists. If you use non-Delta dentists, you’re responsible for your percentage share, plus any amounts the dentist charges above the usual, customary, and reasonable (UCR) rate.
Before getting treatment for more than $300, have your dentist submit a predetermination of benefits to Delta Dental so you’ll know how much your plan will pay and the portion you’ll be responsible for.
Benefits and Covered Services
| Delta Dental PPO Dentists* | Delta Dental Premier Dentists* | Non-Delta Dental Dentists* | |
|---|---|---|---|
| Deductible | None | $50 per person / $100 per family each calendar year | $50 per person / $100 per family each calendar year |
| Benefit Maximum | $2,500 | $2,500 | $2,500 |
| Diagnostic and Preventive Services (exams, cleanings, X-rays, sealants) | 100% | 100% | 100% |
| Basic Services (fillings, simple tooth extractions, night guards) | 90% | 80% | 80% |
| Major Services (crowns, inlays, onlays and cast restorations, bridges and dentures, implants) | 60% | 50% | 50% |
| Orthodontic Benefits | 50% | 50% | 50% |
| Orthodontic Maximum | $2,500 Lifetime | $2,500 Lifetime | $2,500 Lifetime |
* Reimbursement is based on PPO contracted fees for PPO dentists, Premier contracted fees for Premier dentists, and program allowance for non-Delta Dental dentists.
Did Your Dentist Drop Delta?
If your dentist no longer accepts Delta Dental insurance, you can search for a new in-network provider by visiting Delta Dental.
Add More Convenience to Your Dental Care
- Get a virtual dental screening from a Delta Dental PPO or Premier dentist by using the quip app. Just answer a few questions about your oral health and take photos of your mouth from your smartphone to receive a personalized assessment report within 24 hours. To get started, visit the Delta Dental website to register and create an account. Then, download the quip app to your smartphone or tablet, and log in to schedule your appointment.
- Get a real-time video appointment with a PPO or Premier Delta Dental dentist who can provide urgent care, an e-prescription (sent right to your pharmacy), or a dental check-in through a virtual dental consult. Best of all, there’s no cost to you.
- Manage your dental benefits through the Delta Dental website. You may register to view your policy information, check the status of a claim, or gain access to your enrollment information and print out an ID card.