Delta Dental Insurance Review

The plan is a dental PPO that is administered by the Delta Dental Insurance Company, which is the oldest and largest dental benefit plan in the United States. The plan is available to active members and their families in the 50 states and in the Virgin Islands. Eligible family members includes spouse, domestic partner, unmarried dependent children until their 26th birthday, any unmarried child of any age who is not self-supporting due to mental or physical illness. The plan will also cover grandchildren, stepchildren, adopted children and foster children who are solely dependent on the enrollee.

The Dental Insurance Plan has two parts; Plan A and Plan B. Plan A covers 100% of diagnostic and preventive services. Plan A has a maximum benefit amount of $1,350 dollars per year. Plan B covers 80% of diagnostic and preventive services and has a maximum benefit amount of $1,000 per year. Other services offered by both plans during the first twelve months enrolled include 80% coverage on denture repair for Plan A, 50% for Plan B, and 50% of fillings, root canal and oral surgery on both plans A and B. After the first twelve months of membership, coverage expands in both plans to include periodontics, crowns, dentures and treatment for TMJ (Temporomandibular Joint Dysfunction).

As a member of the Dental Insurance Plan PPO, which is also referred to as the Delta Dental PPO you may choose to use any licensed dentist without notifying the PPO. You may also change dentists without notification. However, to obtain the maximum benefit you may decide to use a Delta Dental PPO dentist. There are currently over 67, 000 Delta Dental PPO dentists across the United States. Fees have already been negotiated with Delta Dental PPO’s for all services so in most instances your out of pocket expense will be lower when using a Delta Dental PPO dentist.

The PPO dentist will handle all paperwork and will be paid directly by the dental plan. The member will receive a statement explaining the amount that was covered by the plan and the amount of the members co-pay. There is no need to pay the full amount out of pocket and wait for reimbursement. Enrollment fees for the plan are based on whether the member seeks an individual or family membership, chooses Plan A or Plan B and the members state of residency.

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