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Delta Dental PPO™

Welcome, Delta Dental PPO™ members

Get started with your preferred provider organization (PPO) plan with Delta Dental and learn how to make the most of your benefits.

All about your PPO plan

Your Delta Dental PPO plan provides the freedom to select your own dentist, but you'll likely save the most when you visit a dentist in the Delta Dental PPO network. Here's how to get started and learn what you need to know about your plan.

To check your coverage for a specific dental service or procedure, log in to your online account and select Benefits overview.

To check your eligibility, log in to your online account and select Benefits overview. From there, you can review the status and history of all members on your plan.

When you log in to your online account, you can easily view your past claims and treatment by selecting Claims & visits or Claims. From there you can find the details of your dental visits, including the services or procedures you received, as well as your cost and the amount your plan paid for each service.

Other benefits

Learn about other benefits your plan may offer and how to access them.

Orthodontic coverage

Not all plans include orthodontic coverage, and for those that do, it varies by plan. Be sure to log in to your account to review your coverage.

If your plan does include orthodontic coverage, you can visit any licensed orthodontist under your plan, but you’ll usually save the most if you choose a Delta Dental orthodontist. To find an in-network orthodontist, you can get a recommendation from your general dentist, search our Find a dentist tool or contact us.

Note: If you're undergoing active orthodontic treatment that started under a previous plan, review your plan booklet to see if your Delta Dental PPO plan includes work in progress coverage.

SmileWay® Wellness Benefits

Some Delta Dental PPO plans offer additional dental benefits each year for those who have been diagnosed with a chronic medical condition that affects oral health. Here are the conditions that qualify for SmileWay Wellness Benefits¹:

  • Diabetes
  • Heart disease
  • HIV/AIDS
  • Rheumatoid arthritis
  • Stroke

(More conditions will be added soon.)

If your plan covers SmileWay Wellness Benefits, each member who qualifies (including dependents) will receive additional benefits² on top of their plan's existing benefits. You may need to opt in to access the expanded coverage.

To determine if your plan offers SmileWay Wellness Benefits, log in to your account and select Benefits overview (or Benefits) and then Optional benefits. You can also contact us.
 

Procedure Procedure code³

Additional coverage per
calendar/contract year

One periodontal scaling and root planing (deep cleaning to treat gum disease) — per quadrant

D4341 (4 or more teeth)

D4342 (1 to 3 teeth)

100% coverage
Plus up to four procedures from the following (any combination)
Prophylaxis (teeth cleaning)

D1110 (adult)

D1120 (child)

100% coverage
Periodontal maintenance (cleaning to monitor and treat inflammation and infection after past gum surgery or treatment)

D4910

100% coverage
Scaling in presence of moderate or severe gingival inflammation (plaque removal)

D4346

100% coverage
  1. Known as SmileWay Enhanced Benefits in Texas. This benefit is not covered under all plans.
  2. Refer to your plan booklet for specific details. SmileWay Wellness Benefits are subject to any applicable maximums and deductibles under the terms and conditions outlined in the Evidence of Coverage. Expanded periodontal coverage may not be included if your plan does not cover any periodontal services.
  3. Current Dental Terminology (CDT) coding and nomenclature are the copyright and a trademark of the American Dental Association, all rights reserved.

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, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan.