Delta Dental Premier Vs Ppo

Welcome to Dental and Vision Benefits, where we aim to provide you with all the information you need to make an informed decision about your dental insurance. In this article, we will compare Delta Dental Premier and Delta Dental PPO, two popular dental plans, to help you choose the one that suits your needs best.

Delta Dental Premier Vs Ppo
Delta Dental Premier Vs Ppo

Understanding Your Dental Plan Options

The Ohio State University Faculty and Staff Dental Plan offers two coverage options: Dental Basic and Dental Plus. While both options provide comprehensive coverage, Dental Plus offers additional benefits for a slightly higher employee payroll contribution.

Dental Basic

Dental Basic is an excellent choice for those who prefer a more affordable plan. It provides both in-network and out-of-network benefit coverage for dental services. By using a provider who participates in the Delta Dental PPO network, you can receive greater benefit coverage. The annual maximum benefit for Dental Basic is $1,500 when using a PPO provider, compared to $1,200 for a premier network provider or an out-of-network provider.

Dental Plus

Dental Plus offers a higher level of benefit coverage, including a lower deductible, higher annual benefit maximum, and a higher lifetime orthodontia maximum with no age limit. Similar to Dental Basic, choosing a provider within the Delta Dental PPO network will give you greater benefit coverage. The annual maximum benefit for Dental Plus is $2,500 when using a PPO provider, compared to $2,000 for a premier network provider or an out-of-network provider.

Understanding Coverage and Benefits

Now that we’ve explored the two dental plan options, let’s take a closer look at the coverage and benefits they provide.

In-Network and Out-of-Network Coverage

Both the Dental Basic and Dental Plus options offer you a choice of network or out-of-network coverage. However, you’ll receive greater benefit coverage if you use a provider who participates in the Delta Dental PPO network.

Diagnostic and Preventive Care

All diagnostic and preventive care, including two cleanings per year, oral exams, and bitewing x-rays, is covered at 100% under both the PPO and Premier networks.

X-Rays, Oral Surgery, and Fillings

For x-rays, oral surgery, and fillings, the coverage varies depending on the dental plan and provider network. With the Dental Basic option, you’ll receive 80% coverage if using a PPO provider and 75% coverage after the deductible is met for Premier network providers. The Dental Plus option provides 80% coverage if using a PPO provider and 75% coverage after the deductible is met for Premier network providers.

Major Restorative Services

For major restorative services such as crowns or bridges, the Dental Basic option covers 55% with a PPO provider and 50% after the deductible is met for Premier providers. Similarly, the Dental Plus option covers 55% with a PPO provider and 50% after the deductible is met for Premier providers.

Orthodontia Services

Orthodontia services are provided through the PPO network at 100% under both the Dental Basic and Dental Plus options. However, the Premier network provides coverage at 50% with a $1,200 lifetime maximum for both networks.

Out-of-Network Providers

If you choose to see an out-of-network provider, please note that you will be responsible for a $100 annual deductible and higher coinsurance for dental services.

Understanding Your Vision Plan Options

The Ohio State University Vision Plan offers two options: Vision Basic and Vision Plus, both within the Vision Service Plan (VSP) Choice Network.

Vision Basic

With Vision Basic, you have a choice of network or non-network coverage. However, please keep in mind that the vision plan pays less for covered services when you use a non-network provider. There is a $25 deductible for materials only, such as eyeglasses. This deductible does not apply to your eye exam. Vision Basic provides 100% coverage for a routine eye exam in-network once per plan year. Frames are covered once every other plan year, up to a $155 frame allowance. Glass lenses are covered once per plan year.

Vision Plus

Vision Plus, like Vision Basic, offers a choice of network or non-network coverage. The annual maximum benefit for Vision Plus is $2,000 when using a PPO provider, compared to $1,500 for a premier network provider or an out-of-network provider. In addition to the benefits provided by Vision Basic, Vision Plus offers additional enhancements called EasyOptions. These enhancements allow you to customize your benefit by choosing frame and lens enhancements that best suit your needs.

Conclusion

Choosing the right dental and vision plan is an important decision that can impact your overall health and well-being. Understanding the differences between Delta Dental Premier and Delta Dental PPO will help you make an informed choice. Remember to consider your specific needs and preferences when evaluating the coverage and benefits provided by each plan.

For more detailed information about dental and vision benefits, please visit our website at hr.osu.edu. If you have any questions regarding your benefits, you can reach out to HRConnection via email at HRConnection@osu.edu or call HRConnection at 614-247-6947.