Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania and affiliates
Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania and affiliates
Pennsylvania Marketplace dental plans made simple
Explore our plans available through Pennie and understand what to expect before you enroll.
What to know about ACA dental plans in Pennsylvania
Shopping for dental coverage through the Marketplace looks a little different from a standard dental plan. Here's what to know before you enroll.
Consideration | What it means for you |
|---|---|
| Health plan pairing | In Pennsylvania, you are able to purchase a stand-alone dental plan through Pennie without also buying a health plan. |
| Coverage tiers | Our ACA plans are available in two coverage levels:
|
| What's your cost | Even if a service is covered, you may still pay part of the cost. This could include a deductible, copayment or coinsurance. |
| Adult coverage vs. pediatric coverage | Adult dental coverage varies by ACA plan. Pediatric dental coverage is included as an essential health benefit, and there are limits on how much families pay out of pocket for covered care. |
| Child out-of-pocket limit | For more details about out-of-pocket limits check the plan brochures linked below. |
Marketplace dental insurance plans in Pennsylvania at a glance¹
Choose what works for you. Whether you're looking for coverage that helps keep you healthy with preventive care or protection for more extensive dental services, there's a plan designed to fit your needs.
What ACA dental plan is best for you in Pennsylvania: PPO or DHMO-type?
Delta Dental offers PPO plans and DHMO-type plans through Pennie in PA.
- With a PPO plan, you can visit any licensed dentist and pay less when you stay in the network. Referrals are not required to see a specialist. A PPO plan tends to work well if you already have a dentist you want to keep or prefer flexibility.
- DHMO-type plans typically have lower monthly premiums, but you select a skilled primary care dentist from our network. Your primary care dentist will provide most of your treatment and coordinate any necessary specialist referrals. A DHMO-type plan can be a better fit when keeping the monthly premium low is the priority.
See the in-network plan comparison table below for our specific marketplace dental insurance plans in Pennsylvania.
| PPO Plans | DHMO-type Plans | ||||
|---|---|---|---|---|---|
| Benefit category | Adult Basic | Adult Preferred | Adult Preventive | Adult Basic | Adult Preferred |
| Preventive services (cleanings, oral exams, x-rays) | Covered at no cost | Covered at no cost | Covered at no cost | Covered with fixed copayments starting at $15 | Covered at no cost |
| Basic services (fillings, tooth removal) | Covered at 50% after annual deductible is met | Covered at 80% after annual deductible is met | None | Covered with fixed copayments starting at $50 | Covered with fixed copayments starting at $30 |
| Major services (root canals, crowns, implants) | None | Covered at 50% after annual deductible is met | None | Covered with fixed copayments starting at $390 | Covered with fixed copayments starting at $240 |
| Annual deductible (waived for diagnostic and preventive services) | $50 | $50 | $50 | None | None |
| Annual maximum | $1,000 | $1,000 | None | None | None |
| Waiting period | None | 30 days for major services | None | None | None |
| Network rules | Pick from our large network of PPO dentists | Pick from our large network of PPO dentists | Pick from our large network of PPO dentists | Must choose a DeltaCare® USA dentist | Must choose a DeltaCare® USA dentist |
| How you pay | Plan pays a % coinsurance (e.g., 80%), you pay the rest | Plan pays a % coinsurance (e.g., 80%), you pay the rest | Plan pays a % coinsurance (e.g., 80%), you pay the rest | Fixed copayments $ amounts | Fixed copayments $ amounts |
Adult Basic PPO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
Covered at 50% after annual deductible is met
Major services (root canals, crowns, implants)
None
Annual deductible (waived for diagnostic and preventive services)
$50
Annual maximum
$1,000
Waiting period
None
Network rules
Pick from our large network of PPO dentists
How you pay
Plan pays a % coinsurance (e.g., 80%), you pay the rest
Adult Preferred PPO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
Covered at 80% after annual deductible is met
Major services (root canals, crowns, implants)
Covered at 50% after annual deductible is met
Annual deductible (waived for diagnostic and preventive services)
$50
Annual maximum
$1,000
Waiting period
30 days for major services
Network rules
Pick from our large network of PPO dentists
How you pay
Plan pays a % coinsurance (e.g., 80%), you pay the rest
Adult Preventive PPO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
None
Major services (root canals, crowns, implants)
None
Annual deductible (waived for diagnostic and preventive services)
$50
Annual maximum
None
Waiting period
None
Network rules
Pick from our large network of PPO dentists
How you pay
Plan pays a % coinsurance (e.g., 80%), you pay the rest
Adult Basic DHMO
Preventive services (cleanings, oral exams, x-rays)
Covered with fixed copayments starting at $15
Basic services (fillings, tooth removal)
Covered with fixed copayments starting at $50
Major services (root canals, crowns, implants)
Covered with fixed copayments starting at $390
Annual deductible (waived for diagnostic and preventive services)
None
Annual maximum
None
Waiting period
None
Network rules
Must choose a DeltaCare® USA dentist
How you pay
Fixed copayments $ amounts
Adult Preferred DHMO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
Covered with fixed copayments starting at $30
Major services (root canals, crowns, implants)
Covered with fixed copayments starting at $240
Annual deductible (waived for diagnostic and preventive services)
None
Annual maximum
None
Waiting period
None
Network rules
Must choose a DeltaCare® USA dentist
How you pay
Fixed copayments $ amounts
| PPO Plans | DHMO-type Plans | ||||
|---|---|---|---|---|---|
| Benefit category | Pediatric Basic | Pediatric Preferred | Pediatric Preventive | Pediatric Basic | Pediatric Preferred |
| Preventive services (cleanings, oral exams, x-rays) | Covered at no cost | Covered at no cost | Covered at no cost | Covered with fixed copayments starting at $15 | Covered at no cost |
| Basic services (fillings, tooth removal) | Covered at 50% after annual deductible is met | Covered at 80% after annual deductible is met | Covered at 50% after annual deductible is met | Covered with fixed copayments starting at $60 | Covered with fixed copayments starting at $30 |
| Major services (root canals, crowns, implants) | Covered at 50% after annual deductible is met | Covered at 50% after annual deductible is met | Covered at 50% after annual deductible is met | Covered with fixed copayments starting at $390 | Covered with fixed copayments starting at $240 |
| Annual deductible (waived for diagnostic and preventive services) | $60 | $40 | $60 | None | None |
| Annual maximum | None | None | None | None | None |
| Waiting period | None | None | None | None | None |
| Network rules | Pick from our large network of PPO dentists | Pick from our large network of PPO dentists | Pick from our large network of PPO dentists | Must choose a DeltaCare® USA dentist | Must choose a DeltaCare® USA dentist |
| How you pay | Plan pays a % coinsurance (e.g., 80%), you pay the rest | Plan pays a % coinsurance (e.g., 80%), you pay the rest | Plan pays a % coinsurance (e.g., 80%), you pay the rest | Fixed copayments $ amounts | Fixed copayments $ amounts |
Pediatric Basic PPO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
Covered at 50% after annual deductible is met
Major services (root canals, crowns, implants)
Covered at 50% after annual deductible is met
Annual deductible (waived for diagnostic and preventive services)
$60
Annual maximum
None
Waiting period
None
Network rules
Pick from our large network of PPO dentists
How you pay
Plan pays a % coinsurance (e.g., 80%), you pay the rest
Pediatric Preferred PPO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
Covered at 80% after annual deductible is met
Major services (root canals, crowns, implants)
Covered at 50% after annual deductible is met
Annual deductible (waived for diagnostic and preventive services)
$40
Annual maximum
None
Waiting period
None
Network rules
Pick from our large network of PPO dentists
How you pay
Plan pays a % coinsurance (e.g., 80%), you pay the rest
Pediatric Preventive PPO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
Covered at 50% after annual deductible is met
Major services (root canals, crowns, implants)
Covered at 50% after annual deductible is met
Annual deductible (waived for diagnostic and preventive services)
$60
Annual maximum
None
Waiting period
None
Network rules
Pick from our large network of PPO dentists
How you pay
Plan pays a % coinsurance (e.g., 80%), you pay the rest
Pediatric Basic DHMO
Preventive services (cleanings, oral exams, x-rays)
Covered with fixed copayments starting at $15
Basic services (fillings, tooth removal)
Covered with fixed copayments starting at $60
Major services (root canals, crowns, implants)
Covered with fixed copayments starting at $390
Annual deductible (waived for diagnostic and preventive services)
None
Annual maximum
None
Waiting period
None
Network rules
Must choose a DeltaCare® USA dentist
How you pay
Fixed copayments $ amounts
Pediatric Preferred DHMO
Preventive services (cleanings, oral exams, x-rays)
Covered at no cost
Basic services (fillings, tooth removal)
Covered with fixed copayments starting at $30
Major services (root canals, crowns, implants)
Covered with fixed copayments starting at $240
Annual deductible (waived for diagnostic and preventive services)
None
Annual maximum
None
Waiting period
None
Network rules
Must choose a DeltaCare® USA dentist
How you pay
Fixed copayments $ amounts
Network availability may vary by zip code.
*For plan-specific details like basic services, major services (root canals, crowns, implants, orthodontics) and waiting periods² for both adults and children, explore plan brochures for Pennsylvania.
Plan brochures (PDFs)
PPO Plans for Families - Basic
PPO Plans for Families - Preferred
PPO Plans for Families - Preventive
DHMO-type Plans for Families - Basic
DHMO-type Plans for Families - Preferred
The family plan brochures include both adult and pediatric benefits.
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When to enroll in an exchange marketplace dental plan
You can sign up for a Marketplace dental plan during the yearly Open Enrollment period. In Pennsylvania, Open Enrollment runs from November 1, 2026, through January 15, 2027. To have coverage start on January 1, 2027, you must enroll by December 15, 2026.
You may also qualify for a Special Enrollment Period (SEP) if you experience a qualifying life event, such as getting married, having a baby or losing other health or dental coverage.
Enrollment dates and rules vary by state and individual circumstances. Visit HealthCare.gov to check enrollment deadlines and options available in your area.
How to find your ACA dental coverage in Pennsylvania
- Shop for dental plans in Pennsylvania at Pennie. Note that most exchanges require you to enroll in a medical plan before you can get a dental plan.
- Check your timeline to make sure you enroll during the annual Open Enrollment Period.
- Get additional questions answered by reaching out to a customer service representative at Pennie.
Looking for coverage outside of Pennsylvania?
Find plans by state.
Are you a business owner?
Learn more about plans for small businesses.
Connect with a trusted dentist.
Yours may already be in our network!
Have questions about our ACA dental insurance plans in Pennsylvania? We have answers.
Coverage depends on the plan and, for children, whether the procedure is medically necessary. Pediatric dental coverage through Pennie must include basic and major services for children under 19, but cosmetic procedures like teeth whitening typically aren't covered, and orthodontia (braces) is usually covered only when medically necessary rather than for cosmetic straightening.
Most Marketplace dental plans available in Pennsylvania through Pennie do not cover dental implants. These plans usually help pay for services like cleanings, fillings, crowns and tooth extractions and don't have waiting periods for preventive care.
If you need to replace a missing tooth, some plans may cover dentures or bridges. Check each plan's coverage details before you enroll.
People who are eligible to enroll through their state's Health Insurance Marketplace can enroll in an ACA Marketplace dental plan through Pennie. Eligibility is based on where you live and other factors.
No. The ACA Marketplace isn't just for low-income families. Anyone in Pennsylvania who meets eligibility requirements can shop for health and dental coverage through the Marketplace, regardless of income. If you qualify, you may also be eligible for financial assistance to help lower your costs.
It's a good option if you're:
- Self-employed
- An independent contractor or a gig worker
- Work part-time or for an employer that doesn't offer health benefits
- Are an early retiree not yet eligible for Medicare
- Want an alternative to a pricey employer-sponsored plan
Yes, you can buy a stand-alone Marketplace dental plan in Pennsylvania without enrolling in a health plan at the same time. Because Pennsylvania operates its own state exchange, Pennie, state rules allow you to purchase dental-only coverage directly through the exchange.
Check out our Find a dentist tool to search for dentists in your area. Select the network for your preferred plan: either Delta Dental PPO™ or DeltaCare® USA. You’ll likely save the most if you choose the Delta Dental PPO network for the Delta Dental PPO plan and the DeltaCare USA network for the DeltaCare USA (DHMO-type) plan.
You can also search by dentist or practice name, specialty, languages spoken, gender, office hours and which dentists are accepting new patients.
ACA Marketplace dental insurance in Pennsylvania can help lower the cost of dental care by covering services such as cleanings, exams, fillings, crowns, root canals and tooth extractions. There are no waiting periods for preventive care. Coverage, costs and benefits vary by plan. Compare plans through your state's Health Insurance Marketplace or Pennie to find the option that best meets your needs.
¹This benefit information is only a summary and not intended or designed to replace or serve as the plan policy. Limitations may apply for some benefits; some services may be excluded from the plan.
²Limitations and exclusions apply. Please see your plan booklet or policy for a complete description of plan benefits, limitations and exclusions.
Delta Dental PPO is underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA - Delta Dental of California; PA, MD - Delta Dental of Pennsylvania; NY - Delta Dental of New York; DE - Delta Dental of Delaware; WV - Delta Dental of West Virginia. In Texas, Delta Dental Insurance Company provides a Dental Provider Organization (DPO) plan.
DeltaCare USA is underwritten in these states by these entities: CA - Delta Dental of California; DC, FL - Delta Dental Insurance Company; MD, TX - Alpha Dental Programs, Inc.; NV - Alpha Dental of Nevada, Inc.; UT - Alpha Dental of Utah, Inc.; NY - Delta Dental of New York; PA - Delta Dental of Pennsylvania. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. These companies are financially responsible for their own products. The plan is a dental HMO in CA and TX. You may view the DDIC Network Access Plan, as required by the Health Benefit Plan Network Access and Adequacy Act, online at deltadentalins.com. You may also contact us by calling 800-422-4234 to request a copy.
Delta Dental is a registered mark of Delta Dental Plans Association.