Delta Dental Plans

No, with Delta Dental dental insurance plans, you have the freedom to use any dentist you would like. You do not need to select your dentist from a list of network providers to qualify for benefits and coverage.

However, if you purchase a network plan, you have the ability to lower your out-of-pocket costs and receive the greatest savings when you utilize a Delta Dental Network provider.

Delta Dental PPO plans have flexible enrollment options — you can choose from four effective start dates when you purchase your plan. The dates are based on the plan purchase date:

• 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. For example, a plan purchased on July 3rd can be effective July 15, August 1st, August 15th or September 1st.

   

• 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. For example, a plan purchased on July 15 can be effective August 1st, August 15th, September 1st or September 15th.

DeltaCare USA plans have a set effective date based on the plan purchase date: 

• Plans purchased by the 21st of the month will become effective on the first date of the following month. For example, a plan purchased on June 17th would become effective on July 1st.

   

• Plans purchased after the 21st will not be effective until the month after the next. For example, a plan purchased on July 25th would not be effective until September 1st.

With Delta Dental plans, you receive two cleanings per year.

The Dentemax PPO Dental Network features:

• Discounted fees, typically 30% below average charges in your community
• Immediate network discounts
• One of the largest nationwide networks with over 400,000 access points and 111,500 unique providers

Additionally, when you utilize a Dentemax Dental Network provider, your out-of-pocket costs may be lower because they have agreed to a negotiated fee for covered services.

Enrollment materials will be emailed or mailed to you within 7-10 business days of a completed application, depending on the selection made during the enrollment process.

Delta Dental PPO individual plans are available in AL, CA, DE, FL, GA, IL, IN, LA, MD, MS, MT, NV, NY, PA, TX, UT, WV and DC.

DeltaCare USA individual plans are available in CA, FL, MD, NV, NY, PA, TX, UT and DC.

PPO plans help you pay for dental care without offering fixed prices. When you see a dentist in your network, the dentist agrees to charge lower prices, and your plan shares some of the cost. 

Even if you see a dentist that’s out of your network, Delta Dental will still help pay for covered procedures, although you’ll save less than you would at a Delta Dental dentist.

DHMO-type plans have fixed prices for procedures, known as copays. DHMO-type premiums tend to be lower, but you’ll only enjoy coverage at your chosen DeltaCare® USA dentist.

Delta Dental offers individual dental plans and dental insurance for family members that cover many procedures, including braces, dentures and cosmetic procedures such as teeth whitening. 

However, not all plans cover all procedures. You may want to shop around for a plan that best suits your current and anticipated needs. Some plans offered by employers may have different benefits than plans available directly from Delta Dental.

While Delta Dental doesn’t offer individual vision insurance directly, their partnership with VSP® Individual Vision Plans⁶ enables access to comprehensive and affordable vision coverage from VSP.

For basic (e.g., fillings) and major (e.g., root canals, crowns) services, Delta Dental PPO individual plans have a waiting period, which is a time you must be enrolled for specific services to be covered.⁷

However, diagnostic and preventive care services (e.g., exams, x-rays, cleanings) don’t require waiting periods on any plans. DeltaCare USA DHMO-type individual plans don’t have waiting periods.

Please call our Administrative Team at (312) 726-6565 or email us at [email protected].

Some dental plans may work better for you or your family.  Here are a few questions to ask yourself, while reviewing plans:

• Are there waiting periods for certain procedures?

• Does this plan require you to use a network of dentists or can you use any dentist you choose? If the plan has a network, what dentists participate in the plan’s network?

• If I used a dentist outside the plan’s network, what will the benefits be?

• Does the plan charge an enrollment or application fee?

• Is there a deductible on the plan?

• What is the annual maximum?

Dental claims are submitted by dental providers electronically.

Claims can be submitted on your Delta Dental member portal after you register.