Delta Dental PPO

You can choose from many different kinds of dental plans, but Preferred Provider Organizations (PPO) are fae most popular. In fact, more than 80% of dental insurance plans are PPOs.

So why have PPO plans emerged as the popular and smart choice? Because PPO plans offer clear advantages as suggested below.


So why have PPO plans emerged as the popular and smart choice? Because PPO plans offer clear advantages as suggested below.

 A PPO plan can save you more money.

Insurance companies develop a network of dentists who agree to charge you fees that are lower than their usual rates. Those discounts are the deepest when you visit a PPO network dentist.

 You have options and flexibility.

A PPO plan will offer you a variety of choices from a network of dentists. You also have the flexibility to visit any licensed dentist – even out-of-network dentists— but you can maximize your savings and benefits visiting a PPO network dentist who has agreed to lower fees. In other words, your out-of-pocket expense is much less. 


 Delta Dental PPO Plan

You can visit any licensed dentist, anywhere, or keep the dentist you know and trust. Save the most visiting a dentist from our PPO network. These dentists agree to reduced fees, and won’t charge you more than your expected share of the bill. They also complete your claim forms and help you understand your share of the payment

What Does Delta Dental PPO Cover

Generally, dental policies cover some portion of the cost of preventive care, fillings, crowns, root canals, and oral surgery, such as tooth extractions. They might also cover orthodontics, periodontics (the structures that support and surround the tooth), and prosthodontics, such as dentures and bridges. You’re usually covered for two preventive visits per year.

If you get an individual policy, periodontics and prosthodontics may not be available in the first year of coverage. And orthodontics often requires a rider, in which you pay an additional fee, for any kind of policy.

Most plans follow the 100-80-50 coverage structure. That means they cover preventive care at 100%, basic procedures at 80%, and major procedures at 50% or a larger co-payment. But a dental plan may elect not to cover some procedures, such as sealants, at all.

Every plan has a cap on what it will pay during a plan year, and for many that cap is quite low. This is the annual maximum. You pay all expenses that go beyond that amount. About half of dental PPOs offer annual maximums of less than $1,500. If that’s your plan, you’d be responsible for all expenses above $1,500. If you need a crown, a root canal, or oral surgery, you can reach the maximum quickly.

There’s generally a separate lifetime maximum for orthodontics costs.

Most all companies including Delta offer a variety of plans and coverage based premium we can help determine at Woody’s Insurance what may be the most beneficial plan for you.

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Delta Dental PPO Plus Premier Coverage

With this plan, members enjoy outstanding access and considerable savings leveraging two of our national dental networks: Delta Dental PPO and Delta Dental Premier, the largest dental network in the country. This program features two levels of claims savings.

 For the greatest flexibility, members can choose a dentist in our Premier network, which includes three out of four dentists in the country and 96% of dentists in Massachusetts.

 For the greatest value, members can choose a dentist in our PPO network, which includes 20% of Massachusetts dentists.

  • Coverage for diagnostic and preventive care, including routine checkups, restorative care, and oral surgery
  • No claims forms to fill out when services are performed a participating dentist
  • No balance billing participating dentists
  • Coverage for services performed non-participating dentists at a lower benefit level
  • Savings generated through our negotiated fees, our claims processing, and our utilization management program
  • Special plans for smaller businesses (10-49 employees)
  • Rollover Max, which allows a portion of a member’s unused annual maximum to be carried over to the next year, for greater value. Limitations apply, and some programs exclude this feature. Please refer to your benefit materials or contact customer service for more information.

Delta Dental PPO Orthodontics

Proper tooth alignment is important not only for a beautiful smile but also for function. When teeth are aligned, it’s easier to chew and talk. And it’s also important to correct and guide tooth and jaw development as a child grows, in order to ensure a healthy and functioning smile for adulthood. Orthodontic services often referred to as “ortho”, are services, treatment, and procedures used to correct malposed or misaligned teeth. These services can include braces, retainers, and other orthodontic appliances. Your coverage level for orthodontic services depends on the plan chosen your employer/organization. Orthodontic services are a Class IV benefit, usually payable for eligible people up to age 19, and limited to the lifetime maximum per person as specified in your Summary of Dental Plan Benefits.

Delta Dental PPO Cost

Delta Dental plan premiums vary state and plan. According to its website, the plans rank from least to most expensive as follows:

  • DeltaCare USA (HMO)
  • Delta Dental Patient Direct
  • Delta Dental PPO
  • Delta Dental Premier
  • Delta Dental PPO Plus Premier4

Below is an example of sample quotes for two adults aged 35 and 34 with two children residing in Chicago.5

 Gold PlanSilver PlanBronze Plan
Office Visit Co-paymentNoneNoneNone
Plan Dollar Maximum Per Person, Per Year$1,500$1,000$500
Deductible$50 per person, per benefit year for all services$75 per person, per benefit year for all services$25 per person, per benefit year for all services
Annual Contract RequiredYesYesYes
Waiting PeriodsMay applyMay applyNone
Cost Per Month$125.46$105.27$61.93