Delta Dental Fee Schedule 2023

If you’re looking for dental insurance options, you’ve come to the right place. In this article, we will provide you with all the essential information about Delta Dental’s DPPO dental option for 2023. Whether you’re a beginner or have some knowledge about dental plans, we’ve got you covered.

Delta Dental Fee Schedule 2023
Delta Dental Fee Schedule 2023

Flexibility and Coverage: Delta Dental’s DPPO Dental Option

Delta Dental’s DPPO plan offers great flexibility and coverage options for dental care in the state of Tennessee. With over 2,000 in-network PPO providers, you have the freedom to choose any dentist you prefer. It’s important to note that there are different co-insurance levels for PPO and non-PPO providers.

For new entrants, there are waiting periods for certain treatments. Dentures and crowns have a six-month waiting period, while orthodontia and replacement of missing teeth prior to the effective date have a 12-month waiting period.

Membership Benefits: ID Cards and Welcome Kits

Upon initial enrollment, members will receive welcome kits mailed to their homes. These kits include a welcome letter, ID card, and a two-page benefit summary. Additionally, members have the convenience of viewing or printing their ID cards through the mobile app or the member portal.

Premiums and Cost Savings

Starting at just $20.02 per month for employee-only coverage, Delta Dental offers affordable premiums for its members. The state of Tennessee also contributes by paying half of the premium for active state and higher education employees across all coverage tiers. By choosing a PPO provider, you can enjoy significant savings of up to 30%. PPO providers eliminate the need to file claims, deal with balance billing, or worry about hidden charges.

The Importance of Orthodontic Care

Orthodontic care is a common concern among many individuals. Delta Dental’s DPPO plan covers orthodontic treatment for dependents up to the age of 19. However, please note that there is a 12-month waiting period before the coverage kicks in. So, if your effective date is January 1, 2024, orthodontic treatment will not be covered until January 1, 2025.

Understanding Your Dental Network

Delta Dental offers three different dental networks: Delta Dental PPO, Delta Dental Premier, and out of network. With more than 269,000 office locations nationwide for PPO and over 339,000 office locations nationwide for Premier, you have a wide selection of providers to choose from. PPO providers offer an average savings of 30%, while Premier providers offer an average savings of 18%. It’s important to note that out-of-network providers may require you to file your own claims and can result in higher out-of-pocket expenses.

Benefits of Choosing a PPO Provider

Choosing a PPO provider offers numerous advantages. By selecting a PPO provider, you won’t have to worry about balance billing, paperwork, or hidden charges. Your dentist will file the claim on your behalf, and Delta Dental will reimburse the provider directly.

Balance Billing and Plan Allowances

Delta Dental network dentists agree to accept the maximum plan allowance for each service, ensuring you won’t be responsible for paying the difference between their charges and what Delta Dental allows. The maximum plan allowance covered charges for a Delta Dental Premier provider are usually greater than for a Delta Dental PPO provider. Therefore, finding a PPO provider can provide you with the most comprehensive coverage.

How to Contact Delta Dental

If you have any questions or need assistance, Delta Dental has dedicated customer service representatives available to help you. You can reach them at 800-552-2498, Monday through Friday from 7 a.m. to 5 p.m. Central time. For online support, you can visit Delta Dental’s plan web page at Make You Smile. There, you’ll find a wealth of information, including provider search tools, a virtual annual enrollment video, member handbooks, and frequently asked questions.

Accessing Your Benefits: Member Portal and Mobile App

Delta Dental offers convenient online tools to help you manage your benefits. The member portal allows you to view your eligibility status, check the status of a claim, and view or print ID cards. You can also access educational tools and explanations of benefits. For those on the go, Delta Dental’s mobile app, available for Android and Apple devices, provides similar functionalities, including the ability to search for a provider and check the status of a claim.

Oral Health Education and Annual Enrollment Support

Delta Dental values your oral health and offers a variety of resources to help you stay informed. Their oral health resources include educational tools, a kid’s activity book called “Grin for Kids,” and other informative materials. To support your annual enrollment process, Delta Dental provides a virtual annual enrollment video that covers the importance of dental coverage and highlights the key benefits of their plan.

Explore Additional Resources

For additional information and resources, visit tn.gov/partnersforhealth. There, you can find annual enrollment dates, insurance comparison charts, and premium information. Delta Dental’s website also offers a live chat feature for immediate assistance during business hours. If you prefer to submit a ticket or contact the Benefits Administration service center directly, contact information is provided.

Thank you for considering Delta Dental for your dental insurance needs. We hope this comprehensive guide has provided valuable insights into the Delta Dental DPPO plan for 2023. For more information and updates, visit Make You Smile. Have a wonderful day!