Delta Dental orthodontists will submit claims for you. Delta Dental Patient Direct ® is a discount card program based on the Delta Dental PPO fee schedule. However, you will receive the greatest out-of-pocket savings if you see a Delta Dental PPO provider. Refer to your plan booklet for more information about covered services, deductibles and maximums. With this plan, members enjoy outstanding access and considerable savings by leveraging two of our national dental networks: Delta Dental PPO and Delta Dental Premier, the largest dental network in the country. Refer to your plan booklet for details about your out-of-network benefits. Delta Dental Summary Plan Description DELTA DENTAL PPO PLUS PREMIER - COMPREHENSIVE ENHANCED with Orthodontic Coverage Dental Benefit Plan Summary Effective: January 1, 2020 This plan matches the UDB benefit feature for feature. Here is an example of the effective dates based on plans: When does coverage become effective? According to an independent consulting firm, Delta Dental PPO offers the nation’s best effective discount.² This means our networks can deliver the most value through a combination of network size, utilization and discounts. Delta Dental PPO Plus Premier Delta Dental PPO Plus Premier maximizes the advantages of our dual networks. Delta Dental of Virginia has two participating dentist networks — Delta Dental PPO and Delta Dental Premier®. In Florida, Delta Dental Insurance Company provides DeltaCare USA Plan benefits as a Prepaid Limited Health Service Organization as described in Chapter 636 of the Florida Statutes. (3) When visiting a non-Delta Dental PPO dentist, you pay the difference between the dentist's fee and the Delta Dental-approved fee plus the copayment. This PPO provides a high-quality dental network along with significant discounts — typically up to 25% savings over participating dentists’ usual and customary fees. Covered services are paid based on a percentage — if, for example, fillings are covered at 80%, enrollees pay the remaining 20%. Costs depend on the services you need. Your orthodontist will provide you with payment options (monthly, quarterly, etc.). Access to care anywhere! 6 This not only gives you a … These companies are financially responsible for their own products. Limitations and exclusions apply. Choose the best fit and get started. This option offers an added advantage to patients receiving treatment from a Delta Dental PPOSM Provider. This is not the company. However, you will need to visit a DeltaCare USA orthodontist to receive benefits. Delta Dental Premier® network If you have a Delta Dental Premier plan, then you get the most from your coverage when you visit a Delta Dental Premier network dentist. And, with nearly 80% of practicing dentists in our networks, there’s a good chance they’re already visiting a network provider.¹. We offer two plan options, each with distinct advantages. Delta Dental PPO Plus Premier - Plan Details Overview of benefits coverage on the dental plan for State of Arizona employees and retirees. Delta Dental PPO Plus Premier ™ Flexibility and value, times two. However, your out-of- pocket expenses may be more. You may also seek care from a Delta Dental PPO dentist. Best if dentist access is a high priority. In WY, you do not need to select a primary care dentist, but you must visit a network dentist to receive benefits. We cover more Americans than any other dental benefits provider - and strive to make dental coverage more accessible and … Advantages of the Delta Dental PPO Plus Premier Plan: It pays to use Delta Dental network providers — especially those in our PPO network. One set of post-treatment retainers is covered. Delta Dental offers you three great plans to choose from and you can sign up whenever you’re ready. Delta Dental PPO Plus Premier ™ is the best of both worlds. Delta Dental’s PPO network is one of the nation’s largest, with more than 112,000 dentists participating in over 278,000 locations nationwide. Introducing Delta Dental PPO Plus Premier - Dental Access for Minnesota. A way to save Enrollees select a primary care dentist, and this dentist will then coordinate any needed referrals to a specialist.⁵ Covered services provided by their DeltaCare USA dentist have preset copayments (dollar amounts), which are listed in their plan booklet. 8 a.m. - 7 p.m. In the following states, you can maximize your savings when you visit a network dentist, although you may visit any licensed dentist and receive out-of-network coverage: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT. This website is the home of Delta Dental of California; Delta Dental Insurance Company; Delta Dental of Pennsylvania; Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; Delta Dental of West Virginia, Inc. and their affiliated companies. E.g., a plan purchased on June 17 would become effective on July 1. Health Care Marketplace (Exchange) Customers: This feature uses javascript. There are no maximums, waiting periods or deductibles.⁶, producerservices@delta.org We’ll send an overview of the total treatment cost, including how much your plan pays and your share. Your patients’ network options will depend on their plan. PPO Dentist: Coverage percent is based on the PPO Schedule of Fees. DeltaCare USA plans cover 300+ procedures, including no or low copayments for preventive care. More network savings. Costs depend on the services you need, but Delta Dental can help estimate costs before treatment begins. Your orthodontist will provide you with payment options (monthly, quarterly, etc.). In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan. Select any licensed orthodontist under your plan; however, your costs will typically be lower if you choose an in-network orthodontist. SEE BASIC COVERAGE PLAN DETAILS Delta Dental Premier® network If you have a Delta Dental Premier plan, then you get the most from your coverage when you visit a Delta Dental Premier network dentist. DeltaCare USA is underwritten in these states by these entities: AL — Alpha Dental of Alabama, Inc.; AZ — Alpha Dental of Arizona, Inc.; CA — Delta Dental of California; AR, CO, IA, MA, ME, MI, MN, NC, ND, NE, NH, OK, OR, RI, SC, SD, VA, VT, WA, WI, WY — Dentegra Insurance Company; AK, CT, DC, DE, FL, GA, KS, LA, MS, MT, TN, WV — Delta Dental Insurance Company; HI, ID, IL, IN, KY, MD, MO, NJ, OH, TX — Alpha Dental Programs, Inc.; NV — Alpha Dental of Nevada, Inc.; UT — Alpha Dental of Utah, Inc.; NM — Alpha Dental of New Mexico, Inc.; NY — Delta Dental of New York, Inc.; PA — Delta Dental of Pennsylvania. Get … Delta Dental PPO This network provides the best value and lower out-of-pocket costs. In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan. Important COVID-19 updates for enrollees and providers. Choose from more than 50% of dentists. With this plan, even if your Delta Dental Premier dentist is not in the PPO network, you … Review your plan booklet for specific details regarding orthodontic coverage under your plan. Here are … For a low annual membership fee, individuals and families can receive discounted fees when they go to a participating dentist. Orthodontic payment schedules depend on your contract. This preferred provider plan offers the convenience and flexibility of visiting any licensed dentist. To find out, review your Contract, Policy or Evidence of Coverage booklet or check with your benefits administrator. This preferred provider plan offers the convenience and flexibility of visiting any licensed dentist. Delta Dental PPO Plus Premier Delta Dental PPO Plus Premier combines the Delta Dental PPO and Delta Dental Premier networks, which gives you the benefits of Delta Dental PPO and more. 866-760-4080 Individual PPO plans have flexible enrollment. For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website. Note: Under some plans, you may lose eligibility if coverage has lapsed more than 30 or 60 days. This website is the home of Delta Dental of California; Delta Dental Insurance Company; Delta Dental of Pennsylvania; Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; Delta Dental of West Virginia, Inc. and their affiliated companies. ET M - F. Delta Dental PPO plans are underwritten by Delta Dental Insurance Company in AL, DC (Policy- IENT-P-CORE-DC-REV2018), FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. Your coverage begins on the first day of the month following the date we receive your application and initial premium. Delta Dental PPO plus Premier Network You will get the best value from your Delta Dental Plan when you receive your dental care from one of our PPO (greatest savings) or Premier network participating dentists: Under this HMO-type plan, enrollees have their choice of skilled primary care dentists from the DeltaCare USA network. Plans purchased on or after the 15th of the month have effective date options of: the first of the next month, the 15th of the next month, the first of the month after next or the 15th of the month after next. DeltaCare ® USA Delta Dental PPO TM and Delta Dental Premier ® Getting started You don’t need a referral to begin orthodontic treatment. Best if cost management and predictability are priorities. Benefit period : January 1, 2020 to December 31, 2020 Members have access to … Enrollees simply visit a DeltaCare USA contracted dentist and pay the predefined copayment. Dental plans that work for you. You must visit a Delta Dental PPO prosthodontist or Delta Dental PPO orthodontist to receive the maximum in-network benefits under the program. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. Delta Dental’s plans prioritize preventive care and dentist access, which may be able to keep health care costs low. © Delta Dental. Delta Dental PPO plus Premier is Delta Dental’s preferred provider organization (PPO). By combining the extensive size of our Premier network and the deeper discounts of our PPO network, the Delta Dental PPO plus Premier plan can help reduce claims costs. Plus, there are no annual deductibles, waiting periods or maximums to worry about.³. Delta Dental is America's largest and most trusted dental benefits carrier. Premier: Coverage percent is based on the Participating Dentist Maximum Approved Charge (PMAC). 1Your benefits may differ from the general information provided here. If an appliance is not covered, Delta Dental usually covers some of the orthodontic treatment costs. Plans purchased from the first through the 14th of the month have effective date options of: the 15th of the current month, the first of the next month, the 15th of the next month or the first of the month after next. Delta Dental PPO Plus Premier™ – Preventive Plan E.g., a plan purchased on July 3 can be effective July 15, August 1, August 15 or September 1. DeltaCare USA plans are underwritten in these states by these entities: CA — Delta Dental of California; DC (Policy- I-P-DC-dc)  and FL — Delta Dental Insurance Company; MD and TX — Alpha Dental Programs, Inc.; UT — Alpha Dental of Utah, Inc.; NY — Delta Dental of New York, Inc.; NV — Alpha Dental of Nevada, Inc.; PA — Delta Dental of Pennsylvania. If dentist access is a high priority, Delta Dental PPO might be a great fit. Delta Dental PPO Plus Premier Certificate Delta Dental of Kentucky, Inc., issues this Certificate to you, the Subscriber. Coverage varies depending on your plan, but most Delta Dental plans include: This coverage depends on your plan and applies only if you are in active treatment (banding has occurred). It reflects and is subject to a DELTA DENTAL PPO PLUS PREMIER - COMPREHENSIVE ENHANCED Dental Benefits with Orthodontic Coverage Dental Benefit Plan Summary Pipe Trades Services … Its “safety net” feature combines the traditional Delta Dental Premier network with the Delta Dental PPO network, giving members maximum access to participating dentists and maximum savings. Delta Dental PPO Plus Premier Our PPO Plus Premier plans give you the same broad access to dentists in the Delta Dental Premier network, PLUS the opportunity to save even more when you visit a dentist in the Delta Dental PPO network. Delta Dental Unique Dentists Penetration Report, 2019, Dental Actuarial Analytics, 2017 Dental PPO Study, includes all Delta Dental member companies. If you don’t have basic coverage through the UDB or another dental plan, you may want to enroll in the Delta Dental PPO Plus Premier – Preventive Plan. Delta Dental PPOSM and Delta Dental Premier® are open networks that allow enrollees to visit any licensed dentist, either in the PPO network, where you will save the most on out-of-pocket costs, the moderate cost Premier network or outside the Delta Dental network, where there are no cost Delta Dental of Virginia 4818 Starkey Road, Roanoke, VA 24018-8510 800-237-6060 DeltaDentalVA.com Rev 3.2020 Delta Dental PPO plus Premier Benefits for … Plans purchased after the 21st will not be effective until the month after that. *Members will be subject to balance billing for covered services. Get assistance in a language other than English, Viewing your eligibility information online, Finding your Delta Dental plan information, Beware of offers to waive coinsurance amounts, Go Paperless: Access Your Statements Online, Adding a spouse or dependent to your plan, Mobile Online Services – your ID card and benefits on the go. Preparing for orthodontic treatment? The Delta Dental PPO Plus Premier Enhanced Plan is primarily an employee-paid dental plan that will enable you and your family to enjoy the benefits of quality, affordable dental care from dentists in Massachusetts and across the country. Covered services are paid based on a percentage — if, for example, fillings are covered at 80%, enrollees pay the remaining 20%. DeltaCare® USA Plans purchased by the 21st of the month will become effective on the first date of the following month. Open your browser settings and turn on javascript to start finding a dentist. This program features two levels of claims savings. 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