Delta Dental PPO Coverage

Delta Dental PPO plans are among the most widely accepted dental insurance options, providing you with access to a vast network of dental providers. These plans typically offer coverage for preventive care, basic restorative procedures, and major dental work, with varying levels of coverage depending on your specific plan.

Most Delta Dental PPO plans follow a structure where preventive services like cleanings and exams are covered at 100%, basic procedures such as fillings are covered at 70-80%, and major procedures like crowns or root canals are covered at 50%. However, coverage levels can vary significantly between different employers and plan types.

What Services Are Typically Covered

Your Delta Dental PPO benefits usually include coverage for routine cleanings, oral exams, X-rays, fillings, extractions, and emergency dental care. Many plans also provide coverage for more comprehensive treatments like crowns, bridges, and root canal therapy, though these may require meeting your annual deductible first.

Pediatric dental services are often covered comprehensively under Delta Dental PPO plans, with many policies including specialized treatments for children such as sealants and fluoride treatments that help prevent cavities in developing teeth.

Understanding your annual maximum benefit is crucial for planning your dental care effectively. Most Delta Dental PPO plans provide an annual maximum between $1,000 and $2,000, which resets each calendar year. Planning major dental work early in the year can help you make the most of these benefits.

Your plan may also include a deductible that must be met before certain services are covered. Preventive care typically doesn’t count toward your deductible, encouraging you to maintain regular dental visits throughout the year.

Frequently Asked Questions About Delta Dental PPO

Here are some answers to common questions Delta Dental patients often ask.

Do I Need a Referral to See a Specialist?

Most Delta Dental PPO plans don’t require referrals, giving you the freedom to seek specialized care when needed.

Can I See Any Dentist With My Delta Dental Ppo Plan?

While you can visit any licensed dentist, staying within the PPO network ensures maximum coverage and lower out-of-pocket costs.

How Do I Find Out My Remaining Benefits?

You can check your benefits online through Delta Dental’s member portal or call the customer service number on your insurance card.

What Happens if I Need Treatment That Exceeds My Annual Maximum?

You’ll be responsible for costs beyond your annual maximum, but many dental offices offer financing options to help manage these expenses.