Delta Dental offers a variety of dental insurance plans for groups and individuals. Its group plan offerings include dental insurance for families and seniors. Its individual and family plans cover preventive care at 100%, basic services at a lower percentage with a waiting period, and major services at a lower percentage but without a waiting period. Some plans have a deductible, which is the amount that you will pay for care each year before your delta dental insurance will start to cover expenses. Other plans have annual or lifetime maximums, which are the most that the plan will pay for a particular service in a given period.
Preventive care
Dental insurance is a critical part of a family’s health care plan. It promotes proactive dental care, which helps prevent more serious and costly oral problems down the road. Most Delta Dental plans cover regular checkups and cleanings at little or no cost, reducing the need for more invasive treatment. Delta also offers a variety of time-saving tools and resources to help members navigate their coverage effectively.
Delta offers Preferred Provider Organization (PPO) and Managed Fee for Service dental plans that cover a range of treatments. In-network dentists agree to accept a set fee, or Maximum Allowable Fee, for each service, saving you money over going to an out-of-network dentist. These dentists also complete claim forms and advise on questions about your share of costs, which may include deductibles and annual or lifetime maximums.
Basic services
Delta Dental offers a wide range of basic services that help people keep their smiles healthy. These include routine teeth cleanings, fluoride treatments and sealants. The company also offers preventive services like x-rays and exams. Some of these services may have a waiting period. Moreover, the company’s dental plans are not available to everyone. You must qualify for the plan by having a qualifying event, such as marriage or the birth of a child.
Delta Dental’s PPO plans offer a large network of dentists that have agreed to pre-established fees. This saves members money on dental care. These plans have deductibles, annual maximums and coinsurance. You can find more information about the details of a particular Delta Dental plan by viewing its Certificate of Coverage.
Restorative services
Brushing and flossing are important for a healthy smile, but you also need regular visits to the dentist. Delta Dental is one of the leading providers of dental insurance, and their network includes many quality dentists. The company offers a variety of plan options to meet the needs of any family.
Some plans have a Managed Fee-for-Service (MFO) network, which provides pre-negotiated discounts for services provided by Delta Dental Preferred Dentists. These discounts are typically lower than the usual fees charged by dentists.
Co-payments
The Delta Dental PPO plan provides a balance of cost and flexibility. Its members can save the most by visiting in-network dentists who have agreed to accept a discount on our maximum allowable fees for services, which is known as coinsurance.
Moreover, this plan also offers coordination of benefits. This means that your claims will be processed more quickly when you visit a dentist in-network and that you won’t pay duplicate payments for the same procedure.
Like most insurance plans, the Delta Dental PPO plan has a deductible and annual maximums. However, many services such as cleanings, X-rays, and exams are covered from the start. This is because this type of insurance encourages preventive care. This will help you avoid problems such as tooth decay and broken crowns.
Coordination of benefits
Delta Dental offers its members the option of using any participating dentist in the network. Non-participating dentists, however, may charge more than the Delta Dental maximum plan allowance (MPA), which is set by their contract. This extra amount is billed to the member as balance billing.
The MPA is the amount that Delta Dental will reimburse a dentist for services and procedures. It is calculated based on the procedure code, service date and other information provided by the dentist.
If a covered person has dental coverage through more than one insurance plan, the policies are coordinated according to state laws and the rules established by their group contracts. This process is known as Coordination of Benefits. Coordination is especially important for crowns, fixed bridgework, implants, partial or complete dentures and the surgical removal of impacted third molars.