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Is Delta Dental PPO as an insurance any good? Does it cover most procedures?

Public Comments

1. YESSSS ITS AWESOME.... BUTTTTT ONLY if there is a delta dentists nearby annnnd a dental endodentist too, because otherwise if you need a root canal your paying full price or driving many hours call delta and ask if there is both a dentist and a endodentist near you. Also keep in mind these people are your only options for dental work. In the city of worcester MA 200,000 population for example there was only one delta dentist for me to go to. but in DC there are a bunch to pick from. Good luck
2. Delta is a great dental insurance to have! Every plan is different, so request that they send you a booklet explaining your coverage. Another important bit of information I can offer is to check and see how many dentists are IN NETWORK with the delta ppo plan in your area. This is often VERY confusing for patients, but it is very important and can save you tons of money. The best way to explain it is: With PPO insurance you have the option to go to any dentist, in network and out of network dentists. Every dentist has their own set of fees which is referred to as a fee schedule. Delta Dental has their own separate fee schedule which is almost always MUCH cheaper then the dentists fees. When a dentist is in network, they agree to accept deltas fees in lou of theirs. Out of network dentists bill the patient the difference. For example, lets say you have a cleaning which Delta usually covers at 100%. Now lets say the dentist charges $80 for the cleaning but deltas fee schedule will only pay up to $60. If the dentist is in network, they will have to accept the $60 as payment in full and write off the difference. If the dentist is out of network, you will have to pay the $20, even though you have 100% coverage. Again, delta will send you a booklet with your particular breakdown of benefits as each plan is different. The most common coverage is: 100% for cleaning, exams, and x-rays 80% for fillings, perio (deep cleanings), and root canals 50% for crowns, bridges, extractions, and dentures
3. Delta Dental PPO is only the name of a blanket plan. Each individual plan written under it differs. The PPO means that you can go to the dentist of your choice. He/she does not have to be a "participating" or "network" dentist. Although 97% of all practicing dentists in the US are Delta Dentists. All dentists who are "Delta Dentist" have set fee schedules that are determined by Delta to be fair and reasonable for the zip code that the dentist's practice is located. That being said, Delta is usually a good insurance provider for the patients. Dentists do not care for it, because they restrict us in many of the things that we can charge for. They expect us to work for free sometimes. They do have good plans, but each individual plan is different. There is no way to say what your plan will cover with out contacting Delta with your SSN and date of birth. If you, or your dentist calls them, they will send a fax with a break down of all of your benefits.