Current dental plan summaries can be found on the Documents & Compliance webpage.
PPO Plan
The PPO dental plan allows members to use any dental provider, however, members will receive greater benefits with in-network providers. Member out-of-pocket cost will be less if they use a preferred provider in Delta Dental’s PPO or Premier networks. Delta Dental PPO providers offer deeper discounts than Delta Dental Premier providers. Claim forms are not required when utilizing in-network providers. Network participating providers accept negotiated rates which reduce claim costs and out of pocket expenses. If members choose a non-network dentist, the plan will reimburse them a percentage of the allowable charge.
DHMO Plan
The DMO plan requires that members visit participating DMO providers in order to be covered. Members are required, as a DHMO/DMO member, to select a Primary Care Dentist (PCD) from participating dentists in the DMO network. Members must use your selected PCD for all dental services or obtain a referral from their PCD to obtain services from a specialist. The amount members pay for services rendered is based on the plan’s benefit fee schedule.
You can find the contribution rate chart for the dental plan on page 27 of the Benefits Guidebook.