Delta Dental PPO Insurance – Understanding the PPO Dental Plan

Delta Dental PPO insurance network is arguably one of the largest networks, having more than 112,000 dentists participating in over 278,000 locations worldwide. The number of network dentists available in several locations gives you a great selection of qualified dentists.

Delta Dental PPO Insurance: Understanding the PPO Dental Plan

As a Delta Dental member, you have access to the largest network provider and low out-of-pocket costs for the services rendered.

If you enroll in a Delta dental plan through the Health Colorado marketplace, you must use a Delta dental PPO provider to get benefits.

However, if you use a non-PPO provider you will be fully responsible for the charges. Depending on the plan you choose, some plans allow members to visit non-practicing providers however this would mean greater out-of-pocket costs.

If you are considering using a non-participating provider, ensure you are well covered as you will be responsible for the difference between the amount paid by your plan and the amount you were charged.

Your dentist can complete an online form to be a part of your Delta dental network if they are not. Their background will be reviewed and an invitation sent to them.

In summary of the above, you can get your dentist from the Delta dental providers or non-participating providers.

Understanding the PPO Dental Plan

With the PPO dental plan insurance companies come together to develop a network of dentists who agree to charge a specific fee at a rate that is lower than their usual rate.

A PPO plan will offer you a variety of choices you can choose from a network of dentists. The plan goes further to offer you the flexibility you need.

The flexibility comes in terms of the freedom to visit any other licensed dentist not in the network referred to as an out-of-network dentists.

With a PPO plan your out-of-pocket expenses are much lesser as you can maximize your savings.

Benefits of the PPO Dental Plan

The benefits of the PPO Dental plan are numerous, from greater savings to more flexibility and choice, below are some additional benefits:

  • You can save more than 35% on average when you visit a Delta Dental PPO network dentist as your bill will be much cheaper than simply visiting the dentist without a plan.
  • You can be assured of quality care because all dentists in the Delta Dental PPO network have good credentials that meet the requirements of Delta Dental.
  • Your claims go directly to the in-network dentists, this means that you don’t have to pay the full bills upfront and wait to be reimbursed later.
  • With PPO, you won’t be balance billed when you visit a dentist in the Delta Dental PPO network. This means a dentist cannot bill you for the difference between the regular fees and the agreed amount in the network.
  • You get to have a great selection of qualified dentists you can choose from.

FAQs on Delta Dental PPO Insurance

Why Should I Choose Delta Dental PPO?

You should choose Delta Dental PPO because it provides you with the following:

  • It helps you save the most when you choose a dentist in the PPO network
  • With PPO, you can visit your current dentist or any licensed dentist
  • You will be provided with 100% coverage for preventive healthcare services such as x-rays and tests.
  • You can pay just a small percentage for other covered services

What are the two PPO plans Available?

The two PPO plans available are the Delta Dental PPO Basic and the Delta Dental PPO Premium. They are explained below:

Delta Dental PPO Basic

  • The deductible per calendar year is $50 per person and $150 per family
  • The annual maximum per calendar year is $1000 per person
  • Their preventive services such as teeth cleaning and x-rays come with 100% coverage with no waiting periods or deductibles
  • Their basic services such as fillings and tooth extractions have a 50% waiting period and vary according to the state you reside in.
  • Major services such as root canals, crowns, implants, dentures, orthodontics, and teeth whitening are not covered.

Delta Dental PPO Premium

  • The deductible per calendar year is $50 per person and $150 per family
  • The annual maximum per calendar year is #2000 per person
  • Their preventive services such as teeth cleaning and x-rays come with 100% coverage with no waiting periods or deductibles.
  • Their basic services such as fillings and tooth extractions have an 80% waiting period which varies according to the state you reside in.
  • Major services such as root canals, crowns, implants, dentures, and orthodontics have a 50% waiting period.
  • Teeth whitening has %80 percent time which varies according to state.

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