What You Need to Know

Dental health is about more than pearly whites and cavity prevention. Routine dental exams can reveal early warning signs of serious conditions you want to identify as early as possible—things like diabetes, osteoporosis, and some cancers. Gum disease and oral bacterial infections, if left untreated, can also lead to heart disease, clogged arteries, and stroke. That’s why all our dental plans offer free routine exams.

Your Dental Coverage Options

You have a choice of two dental plan options:

  • Delta Dental Preferred Provider Organization (DPPO)
  • Delta Dental Health Maintenance Organization (DHMO)

While the amount you’ll pay for covered services will differ, the dental plans generally cover the same type of services:

  • Preventive and diagnostic services
  • Basic restorative services
  • Major restorative services
  • Orthodontia

What you pay for covered dental care expenses depends on the plan you select, whether you’ve met your annual deductible, and if you’re using a network dentist. Here’s what you’ll pay depending on the plan you choose:

In-Network

  DPPO DHMO*
Annual Deductible
(per person, combined in- and out-of-network)
$50; $150 maximum per family None
Annual Maximum Benefit 
(per person, combined in- and out-of-network)
$1,500 None
Preventive & Diagnostic Services**
Exams, cleanings, X-rays, sealants
Covered 100% Covered 100%
Basic Restorative Services
Fillings, posterior composites
20%, after deductible Covered 100%, after applicable co-pay
Major Restorative Services
Crowns, inlays, onlays, cast restorations
50%, after deductible Covered 100%, after applicable co-pay
Orthodontia
(all covered members)
Not covered Covered 100%, after applicable co-pay

Out-of-Network

  DPPO
Annual Deductible
(per person, combined in- and out-of-network)
$50; $150 maximum per family
Annual Maximum Benefit
(per person, combined in- and out-of-network)
$1,500
Preventive & Diagnostic Services**
Exams, cleanings, X-rays, sealants
20%, after deductible
Basic Restorative Services
Fillings, posterior composites
20%, after deductible
Major Restorative Services
Crowns, inlays, onlays, cast restorations
50%, after deductible
Orthodontia 
(all covered members)
Not covered
* For a list of copays, refer to the Delta Dental Care Patient Charge Schedule.
** Not subject to the deductible and will not apply toward the annual maximum benefit limit.

Back to top

Choosing a Dental Plan

The Dental DPPO plans:

  • Allow you to see in-network or out-of-network dentists. However, in-network dentists will save you money, because they have agreed to charge lower rates for their services.
  • Give you the option to get out-of-network care. If you go out of network, Delta Dental payments are based on the usual reasonable and customary (URC) charge. The URC is determined by Delta Dental based on the range of fees charged by providers in your area with comparable training and experience for the same or similar service. You may be balanced billed by your dentist for any amount in excess of UCR. When you receive in-network care, URC charges do not apply.
  • Require you to pay for out-of-network services yourself and then submit a claim form and wait for reimbursement.
  • Cover up to two preventive visits per year for you and your covered dependents.

Delta Dental DPPO

  • You must pay the annual deductible before the plan starts paying benefits.
  • Orthodontia expenses are not covered.
  • This is a great plan if your dental provider is not in the Delta Dental network and you’re not interested in finding someone new. Don’t enroll in this plan if you or your covered dependents need orthodontia services.

Back to top

Delta Dental Health Maintenance Organization Plan (DHMO)

  • You must designate a primary dentist when you enroll, or Delta Dental will assign a primary dentist to you. Change your primary dentist on the Delta Dental website or by calling Delta Dental. Note: Online changes made by the 21st of the month are processed for the first of the following month.
  • The plan will pay benefits only for in-network care received from your primary dentist. If you visit a dentist who is not specified as your primary dentist, the plan will not pay benefits.
  • This is a great plan if your dental provider is in the Delta Dental network and you think you’d max out an annual benefit maximum.

Back to top

Your dental plan in your pocket

Download the Delta Dental app. You can use it to find a dentist, view your ID card, see an overview of your coverage, and more.

Get the app today

Find a Dental Provider

Delta Dental DPPO

You can use an in-network dentist in the Premier or the PPO network. There are more dentists in the Premier network, but there are better discounts in the PPO network. To find a dentist:

  • Visit the Delta Dental website.
  • Under Your Plan, choose Delta Dental PPO or Delta Dental Premier.
  • Search by specialty, name, and/or location.

Back to top

Delta Dental DHMO

If you enroll in the DHMO, you will need to select a primary dentist, or Delta Dental will choose one for you. To find a dentist:

  • Visit the Delta Dental website.
  • Under Your Plan, choose DeltaCare USA.
  • Search by specialty, name, and/or location.

Back to top

Have a dental-related question?

Visit the Delta Dental website for articles on topics like diabetes and oral health, sensitive teeth, TMJ, baby bottle tooth decay, vegetarians, and much more.

Go to Delta Dental