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Delta Dental Enrollee FAQs

Find answers to your questions here

Looking for tips to make the most of your dental plan? Need help choosing a new one? We’ve got the answers you need.

Shopping for a dental plan

Shopping for a plan doesn't have to be intimidating. We've got answers to these common questions to help you find the right plan.

PPO plans help you pay for dental care without offering fixed prices. When you see a dentist in your network, the dentist agrees to charge lower prices than if you didn't have a Delta Dental plan and your plan shares some of the cost. Even if you see a dentist that’s out of your network, Delta Dental will still help pay for covered procedures, although you'll enjoy less savings than at a Delta Dental dentist.

DHMO-type plans have fixed prices for procedures, known as copays. DHMO-type premiums tend to be lower, but you’ll only enjoy coverage at your chosen DeltaCare® USA dentist.

There are many ways to pay for your dental plan. One of the most common is a monthly premium. Depending on your plan, it may also be possible to pay annually, semi-annually or quarterly. You can pay with a credit card, a check, an electronic fund transfer or with other options depending on your specific plan.

If your dentist isn't listed in one of Delta Dental's networks, you can check other plans we offer and their networks. For example, sometimes dentists will be listed in our PPO network but not our DeltaCare USA network (please note, these are different networks available through different plans). If your dentist isn’t in any Delta Dental network, you’ll still get coverage on covered procedures when you visit them with a PPO plan, although you'll enjoy more savings at a Delta Dental dentist. Staying in network is a required part of your DeltaCare USA plan.

We offer plans that cover many procedures, including braces, dentures and cosmetic procedures such as teeth whitening. However, not all plans cover all procedures. You may want to shop around for a plan that best suits your current and anticipated needs. Some plans offered by employers may have different benefits than plans available directly from Delta Dental.

Finding a dentist

Somewhere out there is a dentist who's right for you and your needs. Check out these tips and tools to find your next dentist!

Choosing a dentist is a deeply personal choice, and it’s important to find one you’re comfortable with, whose judgment you trust and who takes time to listen to and address your concerns. It can also be a good idea to find a dentist close to your home, your place of work or public transportation. Check out more tips on choosing a dentist.

If your dentist isn't listed in one of Delta Dental's networks, you can check other plans we offer and their networks. For example, sometimes dentists will be listed in our PPO network but not our DeltaCare USA network (please note, these are different networks available through different plans). If your dentist isn’t in any Delta Dental network, you’ll still get coverage on covered procedures when you visit them with a PPO plan, although you'll enjoy more savings at a Delta Dental dentist. Staying in network is a required part of your DeltaCare USA plan.

If you have a PPO plan, visiting dentists in a PPO network maximizes your savings. Depending on your plan and the dentist you visit, some procedures could cost you as little as 20% of what a dentist would normally charge or may even be free.

If you have a DHMO-type plan, you’ll only get the fixed copay prices at your chosen DeltaCare USA dentist. Staying in network is a required part of your plan.

If you need to see a specialist, your dentist should be able to provide recommendations. If you have a PPO plan, you can see any specialist you like (although you’ll save the most when you see a specialist in your PPO network). If you have a DeltaCare USA plan, you'll need to see a specialist that your primary care dentist recommends to you. This is one of the big differences between these two kinds of plans.

On our Find a dentist page, enter your address, the network you want to search and any keywords you may want to search for, such as the dentist’s name, practice’s name or specialty. Then just click Search!

If you have a Delta Dental PPO plan, you can visit any licensed dentist. There’s no need to tell us if you decide to change dentists. If you visit a dentist outside of the Delta Dental network, though, you may have to submit claims yourself and pay for care up front.

If you have a DeltaCare USA plan, please call 800-422-4234 or visit your online account to change your primary care dentist. Any changes received by the 21st of the month will go into effect on the first day of the following month.

If you’re having difficulty finding a dentist near you, there are a few actions you can take.

Expand your search radius. You can search up to a 75-mile radius.

Try searching in a different network. You may find dentists in different Delta Dental networks within your area (although limitations about who you can see while still enjoying your benefits and coverage may apply, depending on your network).

Consider searching for a dentist in other places you frequent. You may find dentists you like near your office or school.

Ask a local dentist to partner with Delta Dental.

Understanding my plan

Understanding the basics of dental insurance is one of the best ways to ensure that you know exactly what you're getting when you purchase a plan. Here are answers to some common questions you may have when shopping for plans.

PPO plans help you pay for the care you receive from your dentist. When you see a dentist in your network, you will pay a lower price for covered procedures and Delta Dental pays some of that price. Even if you see a dentist that’s out of your network, Delta Dental will still help pay for covered procedures, although you'll enjoy more savings at a Delta Dental dentist.

DHMO-type plans have fixed prices for procedures, known as copays. DHMO-type prices tend to be lower, but you’ll only enjoy the coverage at your chosen DeltaCare USA dentist. Staying in network is a required part of your DeltaCare USA plan.

If your dentist isn't listed in one of Delta Dental's networks, you can check other plans we offer and their networks. For example, sometimes dentists will be listed in our PPO network but not our DeltaCare USA network (please note, these are different networks available through different plans). If your dentist isn’t in any Delta Dental network, you’ll still get coverage on covered procedures when you visit them with a PPO plan, although you'll enjoy more savings at a Delta Dental dentist. Staying in network is a required part of your DeltaCare USA plan.

You can find common terms on our website.

You may receive an ID card as part of your welcome package when you get a Delta Dental plan. Your dentist’s office staff can use your ID card to quickly look up your benefit and coverage information.

If your plan didn't include an ID card or you don’t have yours with you, don’t worry! Your dentist can look you up with other identifying information, such as your name, address and Social Security number.

You can add dependents during the initial sign-up process. If you have a dental plan through your employer, we’ll get information about eligible family members from them. Please follow the procedures at your employer to add, delete or change information about family and dependents. Please contact our Customer Service directly if you have a DeltaCare USA plan or coverage through AARP.

If you’re having minor issues with your dentist, we encourage you to first communicate directly with your dentist to resolve the issue. If you can’t resolve the issue together, you can file an online grievance report or contact our Customer Service.

If you’re unhappy with the care you’ve received, we can review your care or arrange for you to be examined by a consulting dentist in your area. If we find that your care wasn’t satisfactory, we will ensure that your original dentist either fixes the issue at no additional cost or else grants you a refund.

If you’ve been the victim of fraud or are suspicious of fraud, you can complete our online Fraud Report Form or call our toll-free anonymous hotline: 800-526-1852.

If you’ve been the victim of a serious crime, please don’t hesitate to contact the police.

We offer plans that cover many procedures, including braces, dentures and cosmetic procedures such as teeth whitening. However, not all plans cover all procedures. You may want to shop around for a plan that best suits your current and anticipated needs. Some plans offered by employers may have different benefits than plans available directly from Delta Dental.

Using my coverage

Once you have your plan, it's important to get the most out of it. Here are answers to common questions about using your plan.

You can log in to see your benefits (or create an account if you don't already have one). Once you've logged in, you can view your benefits overview and your benefits details.

When you need dental care, your dentist will discuss your treatment options with you. These options will take your problem, benefits and coverage, and costs into consideration.

With PPO plans, you can get a pre-treatment estimate from your dentist prior to starting dental care. With a DeltaCare USA plan, you can look up the copays for covered procedures in your plan booklet. You can also look up copay and coinsurance amounts with your online account.

You should pay your dentist directly for the care you receive. When you receive claims statements from Delta Dental, these notices are not bills, but instead summaries of the care you received from your dentist and its costs.

We offer plans that cover many procedures, including braces, dentures and cosmetic procedures such as teeth whitening. However, not all plans cover all procedures. You may want to shop around for a plan that best suits your current and anticipated needs. Some plans offered by employers may have different benefits than plans available directly from Delta Dental.

Depending on the severity of your emergency, the best thing to do may be to head to the emergency room or hospital for immediate care. If you’re having a less serious emergency but still need care when your dentist is unavailable or you’re traveling, your plan may cover it. Please see your plan’s documentation for the specific details.

Your claims statement (also known as an explanation of benefits, or EOB) breaks down care you've already received from your dentist and the associated costs. Your claims statement is not a bill. Payment for the care you receive should go to your dentist, not Delta Dental.

Refer to this video for a more detailed breakdown of the parts of an Explanation of Benefits statement.

If you need translation of written materials or interpretation services over the phone or in-person at your dentist, you can use our Language Assistance Program to make communicating easier.

Getting the most out of your insurance

Once you have your plan, it's important to get the most out of it. Here are answers to common questions about how to get the most out of your coverage.

Having coverage from more than one dental plan is known as dual coverage. How dual coverage works can differ based on the types of dental plans you have.

If your dental needs are different due to pregnancy, your plan may include pregnancy benefits. Please see your plan’s documentation for the specific details.

We recommend visiting your dentist for regular check-ups and cleanings. You may need to see your dentist more frequently depending on your individual needs.

Regular preventive care is essential to preventing potential dental issues from arising in the future. You can help keep your smile healthy and bright by visiting your dentist for regular check-ups and cleanings.

In addition to dental coverage, your Delta Dental plan currently offers access to discounts on hearing aids and vision care through our partners. Learn more about Hearing discounts here: Amplifon and Lasik here: QualSight.

Coverage through your job

The dental plans offered by employers can be different from the plans available directly from Delta Dental. Here are some answers to common questions about employer-offered plans.

If you’ve signed up for a Delta Dental plan directly with us or through Costco or AARP, please see your Certificate of Coverage for answers to common questions and an explanation of your plan’s benefits. You can also create an online account or contact Customer Service for help finding answers. If you have a Delta Dental plan through your employer, your HR department can help explain your plan and your benefits to you.

Having dental coverage from more than one source is known as "dual coverage." How dual coverage works can differ based on which Delta Dental plan you have and who the other source of coverage is, but a brief explanation of dual coverage can be found here.

You can add dependents during the initial sign-up process. If you have a dental plan through your employer, we’ll get information about eligible family members from them. Please follow the procedures at your employer to add, delete or change information about family and dependents. Please contact our Customer Service directly If you have a DeltaCare USA plan or coverage through AARP.

If you lose employer-based coverage, you can get coverage from Delta Dental directly, as well as through your state's health care exchange and through our partners AARP and Costco.

Using online tools and resources

Once you have your plan, it's important to get the most out of it. Here are answers to common questions about using your plan.

You can register an online account on our log in page. Once you've created an account and logged in, you can view your benefits overview and your benefits details.

You can log in to see your benefits (or create an account if you don't already have one). Once you've logged in, you can view your benefits overview and your benefits details.

We have an app available on both Google Play (Delta Dental) and the App Store (Delta Dental Mobile). You can also visit our website from your mobile device to access a mobile-friendly version of the site.

Yes. To pay your premiums online, just log in.

You can set up autopay when you first enroll in your chosen plan, or from your online account.

You can set up paperless billing when you first enroll in your chosen plan, or from your online account.

You can log in to see your benefits (or create an account if you don't already have one). Once you've logged in, you can view your benefits overview and your benefits details.

You can log in to see your claim statements.

To update your address, just contact both your dentist and your employer (if you have coverage through them). We’ll take care of the rest.

If you have a Delta Dental PPO plan, you can visit any licensed dentist. There’s no need to tell us if you decide to change dentists. If you visit a dentist outside of the Delta Dental network, though, you may have to submit claims yourself and pay for care up front.

If you have a DeltaCare USA plan, please call 800-422-4234 or visit your online account to change your primary care dentist. Any changes received by the 21st of the month will go into effect on the first day of the following month.

I have more questions

Dental plans are complex, and you may have questions that weren't addressed here. Fortunately, there are ways to find answers and get the help you need.

You can find a search bar in the top-right. Just enter the terms you want to search for and click the Search button!

If you have additional questions or need assistance with your plan, you can find our contact information on this page: https://www.deltadentalins.com/about/contact/

Just find the Delta Dental company that offers your plan to find the contact information that’s right for you.