Learn more about your preferred provider organization (PPO) plan¹ and how to make the most of your benefits.
Your Delta Dental PPO plan offers a large network of dentists plus savings on out-of-pocket costs for covered services.
Set up your online account, log in and get familiar with your benefits.
Access your plan information anytime by creating an online account. You'll need your enrollee ID number — you can find this in your welcome letter or email. If you can't locate your enrollee ID number, enter your Social Security number with no dashes or spaces. Having trouble? Contact us.
After you log in, you can:
Your plan covers a wide array of of procedures, including preventive, basic and major services. To review your benefits details, log in to your account.
You'll also find your coinsurance percentage (your share of the cost) for covered procedures and the deductible (amount you need to pay before your plan begins to cover dental treatment — does not apply to diagnostic and preventive services). Remember that you'll need to pay any charges for non-covered services and amounts over the plan's annual maximum or the lifetime maximum for orthodontic services.
After each dental visit, you'll be able to find details about your claims and treatment.
Choose a dentist that's right for your needs and understand how to minimize your out-of-pocket costs.
To locate a dentist in the Delta Dental PPO network, log in to your account and select Find a dentist. You can also search the online directory on our website by entering your location and selecting Delta Dental PPO from the drop-down list.
If you can't find a dentist in the PPO network, you can try searching the Delta Dental Premier® network. Keep in mind that your plan dollars won't go as far if you visit a Premier or out-of-network dentist.
Need a dentist that speaks your language or offers extended office hours? From the Find a dentist results page, choose Refine search to filter your search results and find dental offices that provide specific services and amenities.
Network dentists agree to offer services at lower negotiated rates. They're also highly credentialed and meet our strict quality standards, plus you won't have to submit claim forms or wait for reimbursement when you visit a network dentist.
Your plan dollars typically go the farthest when you visit a Delta Dental PPO dentist². Here's why:
Your plan offers limited coverage if you or any covered dependents experience a dental emergency and need care from an out-of-network dentist. You may need to submit a claim form for reimbursement — if so, be sure to include the dentist's detailed billing statement that lists all services or procedures provided. For details about emergency coverage, refer to your plan booklet.
Get your estimated out-of-pocket expense for a procedure before you visit the dentist. Just log in to your account, select Plan ahead for a visit. and then choose Estimate costs. Select the procedure you need and answer any additional questions. You can also compare the fees of up to five dentists in your area.
If your plan doesn't include a cost estimator, you can request a pre-treatment estimate³ from your dentist, who will submit the estimate to us. We'll provide you with a copy that includes an estimate of your coverage and out-of-pocket costs.
After dental visits, find details about procedures you and your dependents have received, as well as your share of the cost, by logging into your account and selecting Claims & visits.
Learn about additional benefits your plan may offer and how to access them.
Orthodontic coverage varies depending on your plan, so be sure to log in to your account to review your coverage. Your orthodontist will submit any paperwork that's needed for pre-authorization, and they'll give you an initial estimate of costs associated with your treatment plan. For more details, review Get the facts straight (PDF, 157 KB).
If your plan includes orthodontic coverage and you (or a dependent) began orthodontic treatment under a previous dental plan, you may be able to continue treatment with the same orthodontist if banding has already been completed. Not all plans include orthodontic treatment in progress coverage, so be sure to review the benefits details in your online account or plan booklet.
Some Delta Dental PPO plans offer enhanced dental benefits each year if you or a covered dependent have been diagnosed with a chronic medical condition that affects oral health. If you qualify, you'll need to opt in to access this expanded coverage. Learn more about SmileWay Wellness Benefits.⁴
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 Benefits⁴:
(More conditions will be added soon.)
If your plan covers SmileWay Wellness Benefits, you and any dependents who qualify will receive additional benefits² on top of your 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, select Benefits overview (or Benefits) and then Optional benefits. You can also contact us.
Additional coverage per
calendar/ contract year
D4341 (4 or more teeth)
