Member FAQs

Once you’ve received enrollment confirmation with your enrollee ID (or member ID), from the log in page, select Create an account. Choose Enrollee/Adult Dependent from the drop-down menu and follow the prompts to create your account. For more details, review Create and manage your online account.

You do not need to download an app. You can access your online account through our mobile-friendly website to get your plan ID card and detailed information about your benefits. If you'd like to add your ID card to your digital wallet, you can download the Delta Dental mobile app from the Apple App Store or Google Play. Note that the app may not include as many details about your benefits and out-of-pocket costs.

To change your address:
 

• If your plan is through an employer or group: Notify your organization's benefits administrator.
• If you purchased your plan through a health care exchange: Contact the exchange.
• If you purchased your plan directly from Delta Dental: Update your address through your online account, or contact us.
   

Be sure to update your address with your dental office as well.

• It’s convenient. Get your claim statements, pre-treatment estimates and other important plan documents online. You’ll get an email alert every time a new document is available.
• It saves paper. You’ll reduce your ecological footprint.
• It’s faster. No need to wait for “snail mail.”
• It’s easy. Updating your settings takes only a few moments.
  
  

Log in to your account and select Get ID card to view or print your ID card. If you'd like to email the ID card to yourself or save it to your digital wallet, you can download the free Delta Dental mobile app, sign in and select either of those options from the home page.

You don’t need an ID card to visit the dentist. Your dentist’s office can look up your benefit and coverage details with some basic personal information, including your member ID. You can find your member ID by checking your welcome letter or logging in to your online account.

No, the same ID card can be used by you and your covered dependents.

Here’s how to search for an in-network dentist in your area:
 

1. Go to Find a dentist
2. Enter your address, city or ZIP code
3. Select your network from the drop-down list
4. Choose Find a dentist

If you’d like to narrow your search results, select Filter on the results page and choose any combination of amenities to focus on.

Don’t know your network? Log in to your account and select Find a dentist to search your own plan's network.

Delta Dental PPO™: Your plan dollars typically go the furthest when you visit a dentist in the Delta Dental PPO network. These dentists agree to offer services at lower negotiated rates. Also, PPO network dentists submit claim forms for you. If you go out of network, you’ll likely pay more out of pocket, and you’ll need to submit your own claim form and wait for reimbursement. Learn more about your PPO plan.

DeltaCare® USA: To receive coverage, you must visit a DeltaCare USA general dentist at your selected dental facility. When you visit your DeltaCare USA general dentist facility, you’ll pay set copayments for each covered service, and you won’t need to submit any claim forms. For more details, refer to the FAQs about DeltaCare USA on this page, or visit the DeltaCare USA members page.

Delta Dental PPO™: You can visit any specialist you like, though you’ll typically save the most when you visit a specialist in the Delta Dental PPO network. You don’t need a referral to see a specialist. Learn more about your PPO plan.

DeltaCare® USA: Your general dentist at your primary care dental facility will coordinate all your care and refer you to a specialist. If you visit a specialist without a referral from your primary care dentist, you won’t be covered, even if the specialist is in the DeltaCare USA network. For more details, refer to the FAQS about DeltaCare USA on this page, or visit the DeltaCare USA members page.

If you’re having difficulty finding a dentist near you, you can:
 

• Expand your search radius. From your search results in Find a dentist, select Filter and try expanding the search radius up to 75 miles in the Distance filter. Select Apply.
• Try searching near other areas you frequent. In the Find a dentist tool, enter the address or ZIP code of your work or school.
• Try searching in the Delta Dental Premier network (PPO only). If you have a PPO plan, from the Find a Dentist search results page, select Filter, then Networks. Check Delta Dental Premier, then select Apply.

If you’re still having trouble finding a dentist near you, contact us.

To receive coverage, you must visit a DeltaCare USA general dentist at your selected dental facility. You can select a DeltaCare USA general dentist by logging in to your online account. You can also contact us.

To select or make changes to your DeltaCare USA general dentist online:

Log in to your account.
 

1. In the Your dental facilities section, choose Select facility (or Change facility if you already have one).
2. Search by ZIP code, select a facility by entering the six-digit facility ID, or have the system automatically select the facility closest to your address.
3. Submit your selection.

If we receive your selection from the first to the 15th of the month, you can start visiting the facility right away. If we receive your selection from the 16th to the end of the month, you can start visiting the facility on the first of the following month.

If you do not have an assigned DeltaCare USA general dentist: You can go to any DeltaCare USA general dentist that is accepting new patients. When that dentist files a qualifying claim, you will be added to their roster and they will become your assigned DeltaCare USA general dentist. Once assigned, you must visit this dentist for future visits to receive benefits. You may change your assigned dentist at any time.

Learn more about your DeltaCare USA plan.

Locate your dentist in our Find a dentist tool and be sure they’re in the DeltaCare USA network. You can find the six-digit facility ID in the dentist’s listing.

No, you can select different facilities for different family members². When you log in to your account to select or change a facility, you'll have the option to add other family members to your selection. Or, you can select a different facility for them by choosing their name from the drop-down list on the home page.

Note: Adult dependents must select their facility through their own online account, unless they authorize you to view their information and select or change their facility. For more details, review the following FAQ, “How can I select a facility for an adult dependent on my DeltaCare USA plan?”

Your adult dependent needs to authorize you to select their facility (or they can create their own account and select their own facility). To authorize you, they can do one of two things:
 

1. Log in to their online account (they'll need to register first), select My account and then choose Yes for the authorization statement. After they select Save, you'll be able to log in to your account and select a facility for your adult dependent, as well as view their treatment details.
2. Print, complete and mail a signed HIPAA authorization form (PDF, 38 KB).

If you have questions or need assistance, contact us.

Delta Dental PPO™: You can visit any licensed dentist anytime. You don’t need to tell us if you decide to change dentists. Remember, if you visit a dentist outside of the Delta Dental network, your out-of-pocket costs may be higher, and you’ll have to pay for care up front then submit a claim for reimbursement.

DeltaCare® USA: You’ll need to change your primary care dental facility before you visit the new dentist, otherwise you won’t be covered³. For details and instructions, visit our DeltaCare USA members page.

Wish your dentist was in your plan's network? Submit a referral and we'll invite your dentist to join.
 

• Recommend a dentist for the Delta Dental PPO network
• Recommend a dentist for the DeltaCare USA network

Note: Submitting a recommendation may not necessarily result in your dentist joining the network.

To check the status of your plan, log in to your online account (or create an account if you don't already have one). Once you’re logged in, select Plan summary. To see if your plan is active, check the Start date and End date in the first section. To view the status of your dependents, go to the last section and select each name. If they’re currently covered, they’ll show as active in the Eligibility section. If they’re not currently covered, they're listed as inactive.

You can also review your plan booklet, Policy and Benefit Details or Evidence of Coverage. If you have questions and your dental plan is through your employer or another organization, contact your benefits administrator.

Delta Dental PPO™: You have the freedom to visit any licensed dentist, but you’ll likely save the most when you visit a PPO dentist. You pay a percentage of the dentist’s fee for covered services — known as coinsurance — after you meet the deductible. A deductible is the amount you must pay toward services each year before your plan begins to pay (the deductible is waived for preventive services). If you have dependents on your plan, you may have a family deductible as well as an individual deductible. Your plan continues to pay benefits up to the annual maximum each year. Some procedures may require an initial waiting period before they’re covered.

DeltaCare® USA: To receive coverage, you must visit a DeltaCare USA network general dentist. If you selected a DeltaCare USA general dentist during open enrollment or when you purchased your plan, that is your assigned dentist you will need to visit to receive benefits.

There are no out-of-network benefits unless you are away from home and encounter a dental emergency. This means that if you go to a provider outside of the DeltaCare network or to whom you are not assigned, you will not receive dental coverage.  

Selecting your DeltaCare USA dentist

If you have an assigned DeltaCare USA general dentist: Contact your selected general dentist’s dental facility to schedule your appointment.

If you are new to DeltaCare USA and are not yet assigned to a general dentist: Log in to your online account and select Find a dentist. From there, note the facility name of your chosen dentist and return to the home page in your account to select your general dentist facility (you can always log in anytime if you forget your facility name).

You can go to any DeltaCare USA general dentist that is accepting new patients. When that dentist files a qualifying claim, you will be added to their roster and they will become your assigned DeltaCare USA general dentist. Once assigned, you must visit this dentist for future visits to receive benefits. You may change your assigned dentist online or by phone at any time.

If you live in one of the states listed, you do not need to be assigned to a general dentist, but you must visit a dentist from the DeltaCare USA network in your state: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT or WY.

Not sure if you have an assigned general dentist or you can’t recall which facility you selected? Log in to your account or check the welcome letter that was mailed to you. You can also contact us.

As a DeltaCare member, you have comprehensive coverage that covers 350+ procedures, including low or no cost preventative care (like cleanings and exams). You pay fixed prices (also known as copayments) for each covered procedure.  Your assigned DeltaCare USA general dentist will coordinate your care and refer you to a specialist, if needed. There are no deductibles, maximums, waiting periods or claims forms to complete with this plan. For more information, see the “Learn about your benefits and costs” FAQ on the DeltaCare USA members page.

To find your plan benefits and coverage information, log in to your account and select Benefits details. If you have a Delta Dental PPO plan, be sure to review details about your deductibles and maximums in the Benefits usage section of your account. You can also refer to your Evidence of Coverage or other plan documents for information about your benefits and coverage.

To check whether orthodontic coverage is included with your plan, log in to your account and select Benefits details. You can also review your plan documents (policy, Evidence of Coverage or plan booklet).

Delta Dental PPO™: If your plan covers orthodontics, these services may have a separate deductible, maximum or waiting period. Learn more about orthodontics under your Delta Dental PPO plan.

DeltaCare® USA: If your plan covers orthodontics, you’ll need to coordinate your care with your general dentist at your primary care facility. Learn more about orthodontics under your DeltaCare USA.

Delta Dental PPO™: You may be able to check your estimated out-of-pocket expense for a procedure before you visit the dentist by logging in to your account and selecting Plan ahead for a visit, then Estimate costs. If you don’t have an account or your plan doesn’t include a cost estimator, you can request a pre-treatment estimate⁵ from your dentist. The dental office will submit its estimate to us and we'll provide you with a copy that includes an estimate of your coverage and out-of-pocket costs.

DeltaCare® USA: Your plan covers some diagnostic and preventive services at low or no cost, and for other covered services you’ll pay a fixed cost — known as a copayment — for each. To find a list of copayments, refer to your Evidence of Coverage (you can also find this by logging in to your account) or plan booklet.

Yes, as a Delta Dental member, you have access to wellness programs and discounts on health products and services, as well as lifestyle brands, travel and entertainment and much more. Find more details about member perks.

If you or a dependent has a dental emergency that's life-threatening, call 911 or go to the nearest emergency room. For all other emergencies, review your plan-specific information.

Delta Dental PPO™: Contact your dentist for emergency treatment. If you’re traveling or unable to visit a PPO network dentist, your plan covers out-of-network dental care. You’ll likely pay more out of pocket at an out-of-network dentist, and you may need to pay up front then submit a PPO claim form (PDF, 896 KB) for reimbursement. Be sure to include the dentist’s detailed billing statement that lists all services provided.

DeltaCare® USA: Your plan provides limited out-of-network benefits to relieve pain. For details, refer to your Evidence of Coverage or plan booklet. You’ll need to pay up front and submit a DeltaCare USA claim form (PDF, 284 KB) for reimbursement. Be sure to include the dentist’s detailed billing statement that lists all services provided. Nonemergency out-of-network care is not covered, except in certain states¹.

Delta Dental PPO™ members can visit any licensed dentist for emergency dental services. DeltaCare® USA members are only covered outside the U.S. if it’s an emergency⁵, and only up to a certain amount (review your plan booklet or Evidence of Coverage for more details). With either type of plan, you’ll need to pay up front and submit a claim for reimbursement.

Ask the dentist for a detailed receipt or billing statement, and, if possible, have it translated into English to speed up the processing of your claim. The statement should contain the following:
 

• The amount paid in original currency (we’ll convert it into U.S. dollars)
• A list of all the services and procedures provided, including the teeth treated
• Name and address of the dentist
• Date of service

Complete the PPO claim form (PDF, 896 KB) or DeltaCare USA claim form (PDF, 284 KB), as appropriate. Have the dentist sign it, then send the claim form and billing statement to Delta Dental at the address on the form. Find instructions for how to file a claim on the After your visit page.

To submit a claim for services received outside of the United States: 
 

1. Download the claim form for your plan. Complete, print and sign the form.
   •  Delta Dental PPO™ claim form
   •  DeltaCare USA® claim form
     
     
2. Provide documentation of services. Please include a statement of treatment (itemized receipt) and proof of payment from your dentist that includes:
   • Dentist’s name, address, and phone number
   • Date each service was performed
   • Description, procedure code and fee for each service performed
   • List of affected teeth
   • Total cost of services performed
     
     
3. Submit your claim form and all required documents by email.
   Please email the claim form and all required documentation to OOC@delta.org. You will then receive an email confirmation that your request has been received. If any additional information is needed, we will reach out to you by email. Please allow up to 30 days from the date all required documentation is received for the claim to be processed. We suggest you keep copies of the form and documents for your receipts.
   

   
   Note: This email is for services received outside of the U.S. only. For services received within the United States, please submit your claim by mail. Find instructions for how to file a claim on the After your visit page.

Virtual dentistry (also known as teledentistry) allows you to “visit” a dentist over video or by submitting photos of your dental issue over your phone, tablet or other device. The dentist provides a consultation or diagnosis to address your issue and determines if you need to schedule an in-person visit.

Virtual dentistry is available to members covered by Delta Dental PPO plans at no additional cost (coverage limitations may apply)⁶. If you have a PPO plan, contact your dental office to find out if they offer virtual dentistry services, or you can go through another dentist who offers virtual dentistry. Remember that you’ll likely save the most if you visit a PPO network dentist. Some virtual dentistry tools also allow you to receive expert advice without an appointment.

Learn more about virtual dentistry.

After you purchase your plan, you’ll have up to 90 days from the plan effective date to make changes or add dependents — such as a spouse, domestic partner or child (up to age 26) — to your plan. After the initial 90 days, you can add dependents only within 31 days of a qualifying status change. Note that some plan changes may affect the premium you pay. To make changes, follow the appropriate instructions from this list.

• If your plan is through an employer: Contact your organization's benefits administrator.
• If you purchased your plan through a Health Care Exchange (Marketplace): Contact the exchange.
• If you purchased your plan directly from Delta Dental: Log in to your online account. To add a dependent to a DeltaCare USA plan, contact us.

For a complete description of plan benefits, limitations and exclusions, refer to your plan’s Policy and Benefit Details, Evidence of Coverage or plan booklet.

To change your address follow the appropriate instructions from this list:
 

• If your plan is through an employer: Notify your organization's benefits administrator.
• If you purchased your plan through a Health Care Exchange (Marketplace): Contact the exchange.
• If you purchased your plan directly from Delta Dental: Update your address through your online account. If you have a DeltaCare USA plan, contact us.
 
   

Note: Moving to a different state may affect the premium you pay.

If your employer-based coverage ends, you can purchase an individual plan from Delta Dental or through your state's health care exchange. We also offer dental plans through AARP, if you’re an AARP member or would like to join.

To cancel your plan, contact us. For more details about plan cancellation, refer to your plan Policy and Benefit Details or Evidence of Coverage.

If you’re unhappy with the care you’ve received, we encourage you to first communicate directly with your dentist to try and resolve the issue. If the issue persists or you have questions, contact us. If we’re unable to resolve your concerns to your satisfaction, you may file a grievance. For details, review the FAQ on this page, “How do I file a grievance?”

If you believe you have been the victim of or observed fraud, submit an online fraud report 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.

You can file a grievance online, by mail, or over the phone. To obtain a grievance form you can mail in, or to submit a grievance by phone, contact us. For more details, review How to file a grievance on the After your visit page.

If you have a Delta Dental PPO™ plan, you can view your claim statements by logging in to your online account, then selecting Claims & visits. Select Visit details for the dental visit you’d like to view. If you have opted to go paperless and receive all of your plan documents online, you’ll get an email from Delta Dental after every dental visit notifying you that your claim statement is available in your online account. If you haven’t opted for paperless documents, you should receive your claims statement in the mail.

DeltaCare® USA plans don’t typically require claims or claim statements. Instead, members pay a fixed cost (called a copayment) for covered procedures at their selected primary care facility⁷.

An Explanation of Benefits (EOB) (also called a claim statement) is a paper or electronic document provided by an insurance carrier after a claim has been processed. The EOB details the dental treatments and services that were paid for on a member’s behalf. It also includes information about the fees charged and any adjustments made by Delta Dental, as well as your coinsurance payment. The EOB is not a bill — think of it as a receipt for your visit. Typically, you pay any balance that you owe your dentist at the time of the visit.

The submitted fee shown on your claim statement or EOB is the amount that the dental office charges for your service and submits to Delta Dental. The accepted fee is the amount your dentist has agreed to accept from Delta Dental as full payment for the service. If there is a different between the accepted fee and the amount Delta Dental pays, you may owe the balance to your dentist.

If you have a Delta Dental PPO plan: To submit a claim for reimbursement if you pay for services up front (usually at an out-of-network dentist), complete the PPO claim form (PDF, 896 KB), have the dentist sign it, then mail it to the address on the form. Include the detailed billing statement listing all services provided.

If you have a DeltaCare USA plan: To submit a claim for reimbursement when you access out-of-network emergency services (or if you live in certain states7), complete the DeltaCare USA claim form (PDF, 284 KB), have the dentist sign it, then mail it to the address on the form. Include the detailed billing statement listing all services provided.

When you enroll in an individual Delta Dental plan, you pay your premium directly to Delta Dental, either online or by mailing a check. If you have opted to go paperless, you’ll receive an email notifying you whenever a new bill is ready to be paid, and you can log in to pay it. If not, you’ll receive your bills by mail.

To pay online, log in to your account. You can make a one-time payment by selecting Pay my bill, or you can set up autopay. When you pay online, you can use your bank account, debit card or credit card.

Log in to your account and select Set up autopay. Depending on your plan, you may have the option to pay monthly, quarterly, semiannually or annually. You can use your bank account, debit card or credit card for automatic payments. To update or cancel automatic payments, select Manage autopay.