Delta Dental Insurance 101

Delta Dental Plans Association, more commonly known as Delta Dental, is one of the best known dental insurers in the United States. Delta is a not-for-profit association that offers dental plans of all types for companies across the U.S. Their 39 member companies administer dental benefit plans whose main focus is providing and improving access to dental care for all. Today, Delta Dental associates provide dental coverage to over 46 million people through over 80,000 employers and agencies.

Delta Dental insurance offers three major plan types to suit a wide range of needs. The benefits vary by plan, and costs vary by region and employer.

Delta Dental Premier (formerly DeltaPremierUSA)
Delta Dental Premier is a traditional fee-for-service insurance plan. If you have Delta Dental Premier, you can visit the dentist of your choice within or outside their provider network. The dentist bills Delta Dental directly, and Delta Dental pays their portion of the bill (most often a set dollar amount), then sends you an explanation of your portion of the bill, which you pay to the dentist.

Ex. Delta Dental pays $45 for a filling. Your dentist charges $60 for a filling. You pay the dentist $15.

Delta Dental PPO (Preferred Provider Option)
Like the Premier plan, Delta Dental PPO pays a fee for each service. You may also visit any dentist that you choose, but will pay lower fees to dentists who are part of Delta’s Preferred Provider network. The dentist handles all the paperwork and claim forms. Delta generally pays a percentage of the procedure rather than a set dollar amount.

Ex. Delta Dental pays 70% of the fee for an extraction. Your dentist charges $210 for an extraction. You pay the dentist $63.

DeltaCare HMO
DeltaCare focuses on prevention and maintenance of your dental health. When you enroll in DeltaCare, you choose a primary care dentist who will be responsible for your dental care. If you require specialty services – orthodontics or oral surgery, for example – your primary care dentist must refer you for services. You pay a low or no co-payment for any dental services provided.

Ex. Depending on the plan, you may pay a $10 co-payment for office visits, no matter what the procedure.

The cost and availability of each option is dependent on the company through which you enroll. As the nation’s largest provider of dental insurance, the costs are significantly lower than most other plans.