Delta Dental PPO Individual Premium Plan is a plan that covers a percentage of your costs for covered dental services. Once you enroll, you’ll get coverage for diagnostic and preventive care, including exams, cleanings and x-rays. Plus the premium plan also includes specialty coverage for implants, crowns and root canals. ***Plus, receive savings on LASIK™ eye surgery through Qualsight™ and hearing benefits through Amplifon™.
Here are some plan benefits.
Get 100% coverage for preventive dental care such as exams, cleanings and x-rays (no waiting period)
Basic services are covered at 80% with in-network dentist (after deductible)
Major services are covered at 50% with in-network dentist (after deductible)
$50 per enrollee; $150 per family
6 months for basic services; 12 months for major services
Visit any licensed dentist, though you’ll generally save more by visiting a dentist from our PPO network
Now let’s see what this plan includes.**
Delta Dental PPO Individual Premium Plan FAQs
How does the Delta Dental PPO Individual Premium Plan work?
The Delta Dental PPO Plan works by allowing you to choose from a network of participating dentists. These providers have agreed to charge lower fees, which helps reduce your out-of-pocket costs. You can also see dentists outside the network, but you’ll save more by sticking with a participating dentist.
What are the benefits of preventive care with the Delta Dental PPO Plan?
One of the key features of the Delta Dental PPO Plan is its focus on preventive care. The plan covers 100% of the cost for most preventive services such as routine cleanings, exams, and x-rays. Regular oral health maintenance through preventive services not only helps avoid more serious issues but also ensures that you maximize the dental benefits offered by your plan.
Another key feature is this plan’s maximum annual spending limit, at $2,000 it is higher than typical annual caps which tend to be in the $1,000-$1,500 range.
Can I use my Delta Dental PPO Plan for major procedures?
Yes, in addition to covering preventive services, the Delta Dental PPO Individual Premium Plan also provides coverage for major procedures such as crowns, bridges, and root canals. It’s important to check your plan’s details to understand the full scope of your dental coverage.
Does the Delta Dental PPO Plan cover emergency care?
Yes, the Delta Dental PPO Plan covers emergency dental care. Whether you’re dealing with a sudden toothache or an urgent procedure, the plan provides dental benefits to ensure you get the care you need without unexpected financial stress. Consult the plan Policy for a description of plan benefits, limitations, exclusions and waiting periods.
What if I need a specialist?
If you require specialized dental care, such as orthodontics or periodontics, the Delta Dental PPO Plan includes a network of specialists. These specialists are often available through the network, ensuring that your oral health needs are met comprehensively. You can also choose to see any specialist that accepts your Delta Dental PPO plan, but will typically save more by staying in the plan’s network.
How do I know what services are covered under the Delta Dental PPO Plan?
The Delta Dental PPO Plan provides detailed information on what services are covered, including preventive services like cleanings and exams, as well as restorative and major procedures. It’s important to review your dental insurance plan documents or consult with your plan provider or participating dentist to get a full understanding of your dental coverage.
Can I combine my Delta Dental PPO Plan with other dental insurance plans?
You can combine Dental insurance with other insurance plans- this is called dual coverage. Your dentist can help you coordinate the benefits, one dental insurance plan would be primary coverage and the other would be secondary. Be sure to check the specifics of both your dental plan and any other insurance you have.
