Common Open Enrollment Dental Plan Questions
[et_pb_section fb_built=”1″ admin_label=”Section” _builder_version=”3.22″ custom_padding=”0px|||||” locked=”off”][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_padding=”0px|||||”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.9.9″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” hover_enabled=”0″ sticky_enabled=”0″]
How is Delta Dental PPO different from DeltaCare USA HMO?
The plans have different benefits, provider networks and requirements.
Delta Dental PPO: With Dental PPO, you can see any dentist you wish and receive benefits, and you can go directly to any dentist without a referral. If you use a Delta Dental Network or Premier dentist, you will likely pay less because Delta has contracted with these dentists to provide services at reduced prices. Preventive care is covered at 100% of reasonable and customary fees (as determined by Delta Dental). For other services, you pay an annual $75 deductible and then a percentage of the cost of what the dentist charges for the service. Dental PPO also has an annual benefit maximum of $1,500 per covered person and an additional $1,500 lifetime limit per covered person for orthodontic care.
DeltaCare USA HMO: With DeltaCare USA HMO, you must visit the DeltaCare USA primary care dentist designated on your dental ID card to receive benefits under the plan. There is no deductible, no lifetime or out-of-pocket maximum, and no out-of-network coverage. You pay a set fee for each dental service you receive. The schedule of fees can be found on the A&M System Delta Dental website at https://deltadentalins.com/tamus. The DeltaCare USA HMO plan has a limited network and you must reside in California, Colorado, District of Columbia, Florida, Georgia, Maryland, Minnesota, New York, Tennessee, Texas, or Utah to participate in the plan.
Why are PPO dental plans so popular?
PPO dental plans are probably the most common type of dental plan because they provide flexibility to members to see any dentist they choose, while also offering the advantage of seeing in-network dentists for greater benefits. PPO dental plans are also usually considered full coverage dental plans because they typically have benefits for routine services and exams, as well as major services like crowns and extractions.
How much will I pay for certain services on each of the plans?
| Delta Dental PPO | DeltaCare USA HMO | |
| Preventive Cleaning | $0 | $5 |
| Resin filling, front tooth | Plan pays 80% | $22 |
| Root Canal, back tooth | Plan pays 80% | $365 |
| Oral surgery | Plan pays 80% | Depends on services rendered |
| Crowns | Plan pays 50% | $395 |
| Upper and lower denture | Plan pays 50% | $365 |
| Comprehensive orthodontics, such as braces (child) | Plan pays 50% | $1,900 |
Full schedule of fees for the DHMO please visit https://www.deltadentalins.com/tamus/pdfs/highlights-dcusa.pdf
How do I contact Delta Dental to see if my services are covered?
You can call Delta Dental toll-free at 1-800-521-2651 and speak to a Customer Service representative Monday through Friday, 6 a.m. to 6 p.m. CST. You may also fill out a customer service form online at https://deltadentalins.com/tamus.
How do I access my hearing and LASIK discounts with Delta Dental?
• For Amplifon hearing aid discounts, go to https://amplifonusa.com/deltadentalins or call Amplifon at 1-888-779-1429.
• For LASIK pricing, go to https://qualsight.com/-delta-dental.
[/et_pb_text][et_pb_post_nav _builder_version=”4.4.8″][/et_pb_post_nav][/et_pb_column][/et_pb_row][/et_pb_section]
