Delta Dental PPO/Premier Plan

The Delta Dental PPO/Premier plan allows you to use any provider you want.

Dentists/Other Dental Care Providers: You can choose any dentist you want.  However, you’ll pay less when you use a provider or facility that participates in the Delta Dental PPO/Premier network.  

If you access the Premier network and the dentist is not also in the PPO network, you’ll still benefit from receiving the network charge and avoiding being balance billed.

Preventive Care: Preventive care is 100% covered when you use in-network providers.

Annual Deductible: You generally pay an annual deductible before the plan begins to pay for a portion of covered basic and major services. The deductible does not apply to preventive care.

Coinsurance: When you receive any other dental services, you pay a percentage of the cost of the service, and the plan pays the remaining percentage. This is called coinsurance. You will need to pay the annual deductible first before coinsurance applies.

Annual Maximum Benefit: The Delta Dental PPO/Premier plan includes an annual benefit maximum. This is the maximum amount the plan will pay for your dental services each year. Once you reach the annual benefit  maximum, you will pay the full cost of any future dental services for that year.

Orthodontia: You must use the DeltaCare DHMO network. Click here for information - DeltaCare USA DHMO PlanClick here for instructions on searching the DeltaCare network for an orthodontist.

 

Per Pay Period Cost

 

Employee

Only

Employee

Plus 1

Employee

Plus 2 more

Delta Dental PPO $23.88 $47.74 $68.16