Last June in Savannah, Georgia, I sat on my uncle Odell Fitch’s porch with his laptop balanced on a cooler lid, trying to find out whether his dentist was still in the network on his Delta Dental plans card, and I picked PPO from the dropdown on the Find a Dentist page without looking at the other choices, which is how a dentist he’d seen for years came back as not found. Odell went quiet.
Delta Dental plans aren’t one plan, and I found that out on a porch in Savannah. I’m not connected to the company, so I stick to what Delta Dental’s own sites say and to what I fumbled. Here’s what I’d check on my own card before any appointment.
Delta Dental plans confused me until one wrong dropdown in Savannah. Four checks I run now before picking PPO, Premier or DeltaCare USA.
How Delta Dental plans split into PPO, Premier and DeltaCare USA
Odell’s card just said Delta Dental, so I assumed one plan and one list. Wrong. Separate Delta Dental companies run the plans in different states, so the details change with where you live and what your employer picked.
PPO vs Premier networks
On a PPO or Premier plan you can usually see any licensed dentist, but staying in network costs less. PPO dentists accept reduced fees as payment in full and can’t bill you the difference. Premier dentists cost a bit more than PPO ones and likely less than going outside both. A dentist outside the networks can bill the difference. Same dentist, different list.
DeltaCare USA
DeltaCare USA is built differently. You pick a primary dentist from its network, set copayments replace the percentage split, and that dentist coordinates any specialist referral. A neighbor of Odell’s has it, I think, though I never saw her card. If yours is DeltaCare USA, the dentist named on the card is usually the one you use.
What I’d check on my own card
Checking Delta Dental plans against my own card
Back on the porch I wrote four lines on the back of an envelope, and Odell still has it:
- The plan type printed on the card: PPO, Premier, DeltaCare USA or something else.
- Which network my dentist is in, found by trying each choice in the Find a Dentist tool until the name shows up.
- Whether I can go outside the network, and what that would do to my share.
- Which limits apply. PPO-style plans usually have a deductible and an annual maximum, while DeltaCare USA uses copayments.
I’d call the number on the back of the card on a weekday with the group name in hand, because the plan documents decide what’s covered and I can’t. Odell’s rep took six minutes, no, seven, and was nicer than I’d have been.
After a visit, the explanation of benefits shows what the plan paid and what’s left. Odell stacks his under the TV in a shoebox, which I find both impressive and alarming.
Prices change by plan, so I won’t quote any, and rules change from year to year. I’d confirm everything with the plan and the office. This is general information, not medical, legal or financial advice. Check with a professional.
FAQs
1 – Are all Delta Dental plans the same?
Plans differ by state, by employer and by type, and the card alone won’t say how. The booklet or member site for your plan is the reliable list. Odell’s card just said Delta Dental, so I guessed on a porch, which I don’t recommend.
2 – How do I find a dentist that takes Delta Dental plans?
Use the Find a Dentist tool on your plan’s site, and try each network your plan lists. Then phone the office and ask whether they take your exact plan today. Lists lag, and a name can show up under only one network.
3 – What happens if my dentist is out of network?
You may pay more. A dentist outside the Delta Dental networks can bill the difference between their fee and the plan’s allowed amount, so ask the office what that could mean before you book. Odell’s dentist turned out to be on the Premier list, which saved us the whole question.
4 – How do I know which Delta Dental plan I have?
Look at the card, then the booklet or member site, since Delta Dental plans name the type there. If it still isn’t clear, call the number on the card and read them the group name.
5 – Can I use Delta Dental at any dentist?
On PPO and Premier plans you can see any licensed dentist, though in network usually costs less.
Conclusion
Delta Dental plans turned out to be three kinds of plan under one logo, and Odell’s dentist was in the second list all along. The dropdown cost us four minutes. He still keeps the envelope in his shirt pocket.
