Delta Dental Ppo Copay

Posted : admin On 1/29/2022

Already Enrolled?

Our affordable, reliable dental and vision plans are a great option for Kentucky residents who qualify for Medicare. PPO plans from Delta Dental of Kentucky provide exceptional benefits for seniors at budget-friendly prices, all backed by the nation’s largest network of dentists, which means it's easy to find a dental or vision provider right.

Whether you have a Delta Dental Health Care Exchange (Marketplace) plan or you’re still considering one, you can find the answers to your most common questions here.

Delta Dental PPO TM1. Our coinsurance plan shares your costs for covered services. After you meet your annual deductible, Delta Dental pays a percentage of your bill and you pay the rest. You can visit any dentist, but you’ll save the most with a Delta Dental PPO dentist. Delta Dental plans cover a variety of root canal (endodontic) treatments. The most common procedures and typical amounts charged by dentists are: Root Canal – Front Tooth (approximately $620 - $1,100 Out-of-Network) 1; Root Canal – Premolar (approximately $720- $$1,300 Out-of-Network) 1. Delta Dental PPO — EPO Plan Design is the perfect plan for a tight budget. It's a copay plan, so you always know what your cost will be. Rather than showing percentages for coverage levels, covered services are given a fixed dollar amount. You must see a Delta Dental PPO dentist. Delta Dental of Massachusetts PPO and Premier insurance products are offered by Dental Service of Massachusetts, Inc. Delta Dental of Massachusetts EPO and DeltaCare insurance products are offered by DSM Massachusetts Insurance Company, Inc. May only be purchased and used by those who have primary residence in Massachusetts.

  • How do I find the right dental insurance for me or my family?
    How do I get a Delta Dental Health Care Exchange (Marketplace) plan?
    To get stand-alone dental coverage for children, adults, or the entire family, visit healthcare.gov to explore Delta Dental’s ACA-compliant plans.
    What types of exchange plans does Delta Dental offer?

    Delta Dental offers ACA-compliant dental plans in 15 states, plus D.C., including pediatric-only plans and options for families.

    Plans on the Health Care Exchange (Marketplace) are categorized as high coverage and low coverage. A high coverage plan means you’ll pay a little more each month (in premiums), but you’ll owe the dentist less for covered services (and more may be covered!). With a low coverage plan, you’ll pay a little less each month (in premiums), but you’ll owe the dentist more for covered services.

    Beyond offering you high and low dental coverage options for children and families, you can also choose between a PPO and copay plan.


    Delta Dental PPOTM1
    • Our coinsurance plan shares your costs for covered services.
    • After you meet your annual deductible, Delta Dental pays a percentage of your bill and you pay the rest.
    • You can visit any dentist, but you’ll save the most with a Delta Dental PPO dentist.
    • Children can use their benefits immediately — adults may have a waiting period for Major Services.
    DeltaCare®USA1
    • Our copay plan works like a dental HMO.
    • You must visit your selected DeltaCare USA dentist to receive benefits.
    • When you visit the dentist, just pay your predefined copayment and you’re all set.
    • You’ll know all copayments up front, so you can plan ahead for treatment costs.
    • Use your benefits right away — there’s no waiting period on children or adult services.
    When is open enrollment for individuals on the Health Care Exchange (Marketplace)?
    In most states, open enrollment for individual plans on the Health Care Exchange (Marketplace) starts on November 1 to obtain dental insurance for the new year. (For California residents, open enrollment starts on October 15.) Check healthcare.gov for exact open enrollment dates for your state.
    I already have Delta Dental coverage through my employer. What do I need to know?
    If you’re already a Delta Dental enrollee, you should be set with your current group coverage. For questions about your employer plan, reach out to your company’s benefits representative.
    I already have individual dental coverage. What do I need to know?
    If you already have individual dental coverage, you can keep your current coverage or you can explore our plans on healthcare.gov.
    If I purchase medical benefits through the Health Care Exchange (Marketplace), can I still purchase separate dental benefits?
    Yes.
    Do I have to have medical coverage if I want to buy a dental plan on the Health Care Exchange (Marketplace)?
    Yes. In order to purchase stand-alone dental coverage on the exchange, enrollees must have medical coverage.
  • What do I need to know to start using my dental benefits?
    I signed up for a Delta Dental plan, but I haven’t received anything from you. How do I know if I’m enrolled?
    If you’ve recently enrolled in a Delta Dental plan on healthcare.gov or through your state’s Health Care Exchange (Marketplace), it may take up to 10 business days from the date you signed up for your enrollment to be processed. Once your enrollment is activated, you’ll receive a confirmation from us via email and/or postal mail. You can also check your enrollment status online at any time.
    What are Delta Dental’s Online Services? How do I sign up?

    With Online Services, you can find a network dentist, check benefits information (including eligibility and claims), make payments, view or print ID cards and get cost estimates for care. (Note that cost estimates are not provided for DeltaCare USA because copayments are provided up front.)

    Once you’ve received enrollment confirmation from us, simply sign up on our website. Select “Enrollee/Adult Dependent” from the initial drop-down menu and follow the prompts to create your account.

    How do I get an ID card?
    ID cards are not needed to use your benefits. You can simply give your dentist your name, date of birth and social security number or enrollee ID to verify coverage. If you prefer having an ID card in hand, you can print one by logging in to Online Services or you can display it from a mobile device.
    When can I start using my dental benefits?
    Once we’ve received your payment, and you have enrollment confirmation, you can start using your benefits on or after your effective date.
    How can I check my benefits and make payments? Can I do it online?
    The quickest way to check your benefits and make payments is online. Simply log in to your Online Services account from our website. You can also pay your invoice via check or by calling us at 888-857-0337.
  • How do I find or switch my dentist?
    Can I keep my same dentist if I switch to a Delta Dental Health Care Exchange (Marketplace) plan?
    If your current dentist is in-network for the plan type you selected, then you’re good to keep that dentist. If your dentist is not in-network, here’s how it works:
    • With a Delta Dental PPO plan, you can visit any licensed dentist to receive benefits. However, you’ll usually save the most when you visit a PPO network dentist because these dentists accept reduced fees for plan enrollees.
    • If you have a DeltaCare USA plan, you must select a dentist in the DeltaCare USA network to receive benefits.
    How do I find a network dentist?

    To find a network dentist by location, just use our Find a Dentist tool.

    Select the network that corresponds to your plan and click search. For a more targeted search, you can enter the name of your dentist or dental office.

    Can I change my network dentist? How?

    Delta Dental PPO enrollees can change their dentist at any time — there’s no need to notify us.

    DeltaCare USA enrollees who want to select or change their primary care dentist should make the request via our online customer request form or by telephone at 888-857-0337. All DeltaCare USA dentist changes requested by the 21st of the month will take effect the first day of the following month.

Cost Estimator terms of use

Please scroll down and accept to proceed.

Information regarding the Cost Estimator content

If you are experiencing a medical or dental emergency, you should seek appropriate emergency medical or dental assistance, such as calling '911.'
To begin using the Dental Care Cost Estimator tool, click the Agree button below. By clicking, you agree that you have read the information below, are accessing this information for purposes of determining treatment cost estimates for dental care services you are considering receiving, and will not use the information in this tool for a commercial or anti-competitive purpose. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Your actual cost may be higher or lower than the estimate for various reasons.

General information regarding your health care

The information and content (collectively, 'Content') on this website is for your general educational information only. The Content cannot, and is not intended to, replace the relationship that you have with your health care professionals. The Content on this website is not medical advice. You should always talk to your health care professionals for information concerning diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. Health information changes quickly. Therefore, it is always best to confirm information with your health care professionals.

The Dental Care Cost Estimator sometimes groups together, into 'treatment categories,' services that are often delivered together to address a particular dental problem. The description of different treatment categories, and the inclusion of particular services in a treatment category, is not advice that any particular treatment category is the right treatment for you or that you should not obtain any particular treatment. All of those matters are things that you should decide, in consultation with your dental care professionals. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. If you live outside the U.S., you may see information on this cost estimator about products or services that are not available or authorized in your country.

General information regarding your dental benefits

  • Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. For a complete description of the details of your coverage, please refer to your coverage documents. Estimates may vary depending on your benefit plan and the state you live in. Claims will be processed when received according to your plan provisions.
  • You may be responsible for the cost of procedures or services not covered by your plan.
  • Use of this website in no way increases or decreases the benefits available under a dental benefit plan. If there is any conflict or discrepancy between the Content on this website and your coverage documents, your coverage documents will control.
  • Pre-authorizations or referrals are required for certain benefit plans and certain dental care providers. Refer to your benefit plan to determine whether these requirements apply to you.
  • Preventive services are included in this tool. Preventive care coverage varies by plan and by demographic considerations such as age. Refer to your benefit plan to determine whether preventive services are covered for you.

General information regarding cost estimates

  • Do not avoid getting dental care based on the cost information provided on this website.
  • This website shows estimates of certain dental care costs.
  • The version of the Cost Estimator that is available publicly (does not require sign-in credentials) uses aggregated historical cost data for the procedure in question. The secure version (available only after you sign in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data.
  • The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan.
Delta Dental Ppo Copay

More information regarding how cost estimates are calculated

Delta Dental Ppo Copay Insurance

Cost estimates for services provided by out-of-network dentists (available in the out-of-network estimator) are based upon submitted claims data for out-of-network providers. The data is based on actual, non-discounted charges that providers have billed.

Delta Dental Ppo Copay

Cost estimates are specific to geographic areas, as defined by the first three digits of a ZIP code (e.g., the geo ZIP for 12345 is 123).