Delta Dental Insurance Plans

Company Overview & Coverage Options

A fundamental question for consumers shopping for dental insurance is "Will my dentist take my coverage?" because insurance is only as good as dental professionals who accept it. In other words, how good are a plan's dental benefits if they're rejected by your preferred dentist and oral surgeon and orthodontist?

Delta Dental has the distinction of being the single largest dental insurance provider in the United States with over 80 million people enrolled across the plans offered by Delta Dental entities. The company leverages this scale of enrollees to attract a large number of dentists to their networks. According to the company, 128,000 dentists and over 198,000 office locations accept one or more Delta Dental plans. Insurance acceptance differs by plan type. For example, Delta Dental PPO has a national network of more than 68,000 dentists practicing in over 119,000 locations. In comparison, their DeltaCare USA offering has just 22,000 dentist office locations, about a fifth of the number of PPO network locations.

The Delta Dental parent company, Delta Dental Plans Association, is a not-for-profit organization. It was originally formed in 1966, but its earliest precursor began in Washington State in 1954. The company has proven very stable over the years, enjoying enormous market growth in the decades following its creation. By 2008, total premium revenue was around $15 billion. By the same year, Delta Dental member companies processed over 81 million dental claims, or approximately 1.5 million every week, with an accuracy rate of 99.5 percent. The organization itself is comprised of 39 independent companies such as Delta Dental Insurance Company, Delta Dental of California, Delta Dental of New York, Delta Dental of North Carolina, and the Hawaii Dental Service. Not surprisingly, Delta Dental plans are available in every one of the United States as well as Puerto Rico and some other U.S. territories. The brand's success with consumers has enabled them to contribute significant sums to philanthropic dental care efforts. The member companies of Delta Dental contributed $79 million in 2018 to community programs across the country expanding access to oral care to underserved populations. In total, 11 million people were helped through 1,700 separate programs.

Plan Options

Delta Dental has a broad portfolio of plan options for consumers to consider. The plans differ not just on deductibles and out-of-pocket costs for services but also breadth of features and the maximum amount of dental expenses to be covered during a single plan year. Since plan options differ by state, we will use Delta Dental plans available within a single state to illustrate our point.

A very affordably priced Dental for Everyone Gold PPO has the following out-of-pocket costs in 2022 during the first year of coverage (note - this plan increases its coverage from the first year of enrollment to the third year of continuous enrollment):

Our comparison plan is the higher cost Immediate Coverage Plan PPO, which is also from Delta Dental. The Immediate Coverage Plan PPO has the below out-of-pocket costs during the first year of coverage during 2022. As was the case for the Dental for Everyone Gold PPO, the Immediate Coverage Plan PPO increases coverage from the first year of enrollment to the third year of continuous enrollment.

When comparing the two plans above we observe several differences. Immediate Coverage Plan PPO, while having a higher premium, also has lower out-of-pocket costs than the Dental for Everyone Gold PPO for various dental services (e.g. crowns, root canals). It also has a higher maximum benefit. Lastly, while both plans do not have orthodontic coverage in the first year, the Immediate Coverage Plan PPO does have care for orthodontic services beginning in the second year of continuous enrollment.

Issues to Consider When Shopping

Not all dental benefits are equal. Some are more relevant to your personal oral health circumstances than others. For example, a person with straight teeth will find orthodontic benefits less significant than a person with crooked teeth. Consequently, a consumer considering a Delta Dental plan should evaluate the different options in light of what their needs are as well as what services may be likely. A final consideration concerns dental care that may not be anticipated but still may happen. Oral health events like cracked molar or an impacted wisdom tooth don't always provide the early warnings we would prefer. Given these possibilities, it is important to ask the following types of questions of a dental plan you are considering for purchase:

• How would the plan cover an unexpected event like breaking a tooth and requiring a crown?
• How would the plan address the need for a partial denture?
• What is the highest amount of dental expenses the plan will cover in a year?

* Delta Dental is coverage underwritten by Delta Dental Insurance Company and available to members of Benefits Association Inc, in the Enterprise states. (AL, CA, DC, DE, FL, GA, LA, MS, MT, NV, PA, TX, UT and WV)

More From DentalInsurance.com...

Is Delta Dental Insurance Available in Every State?

Yes. The Delta Dental Plans Association offer dental insurance in every state and the District of Columbia (i.e. Washington D.C.). The Delta Dental Plans Association is a a not-for-profit national association based in Illinois. Through all its various companies, the Delta Dental Plans Association provides coverage o 85 million people.

Below is a list of the companies within the Delta Dental Plans Association. In cases where a single company services multiple states, the associated states are noted.

Will Delta Dental insurance plans be changing for 2025?

Annual changes depend on the plan you are considering. Our free dental insurance quote tool can provide you with the latest rates for 2025 Delta Dental coverage and our Plan Details information will alert you to the costs and conditions attending covered dental treatments.

Can I Enroll Any Time of Year?

Privately purchased dental insurance does not have an enrollment period. In other words, consumers are free to apply for coverage whenever they choose. Group plans offered by employers, in contrast, normally have an enrollment period that determines the dates in which dental benefits may be added or deleted.

Can I Add a Child to an Existing Policy or Do I Need to Buy a New Plan?

In most cases a person should be able to update an existing dental plan when a dependent child is added. Depending on the state and the plan, the age of the children may affect their eligibility to be added.

How can I get dental insurance coverage through my employer?

Your employer must have a group dental plan before you may enroll in it as an employee benefit. To determine if your company has dental coverage or to enroll in employer dental coverage, contact your Human Resources representative. Another source of information is your employee benefit handbook. Assuming your company does offer dental benefits, you need to evaluate the employee premium for dental benefits and both the dental services covered and the out-of-pocket costs for those services. You can use this website to compare the value of your company dental plan to stand-alone dental plans that are purchased privately by an individual. Assuming you want to enroll in a company plan, you will likely need to wait until your company’s annual enrollment period. Typically annual enrollment periods for existing workers is in the fall and insurance coverage does not begin until the following January 1st for selections made during annual enrollment. If you need dental coverage earlier than that time, you can consider enrolling in a stand-alone dental plan on websites like this.

Can large group dental plans be customized?

Yes. Dental plan benefits are not standardized so plans decide on what benefits to include at their own discretion. A large group dental plan’s benefits are determined by the employer offering the plan. The employer may decide to offer a preexisting plan design offered from an insurance company or work within an insurance company on a customized dental plan design. Companies can also choose to self-find their dental benefits. In a self-funded model, the responsibility for paying covered dental claims lies with the employer and this obligation is not transferred to a third-party insurance company in exchange for premiums. In a self-funded dental plan, a company decides what benefits are included for employees.

What dental and vision plans are offered by small businesses?

The dental plans and visions plans offered by small businesses are normally group plans. In a group plan, an employer leverages the buying power of aggregate employees in order to negotiate a lower cost for its insurance. Many small businesses do not offer dental or vision benefits and currently there are no federal laws compelling small businesses to offer this benefit. If a small business offers dental or vision coverage, it may be a voluntary benefit selection on the part of the employee for which the employer may charge a premium. Sometimes dental and/or vision benefits may be included within a company’s medical coverage but this is not common.

This website allows consumers to shop for stand-alone dental and vision plans as well as combination dental and vision plans. Some of these plans also add hearing to its covered benefits.

Is Delta Dental Insurance Available in Every State?

Yes. The Delta Dental Plans Association offer dental insurance in every state and the District of Columbia (i.e. Washington D.C.). The Delta Dental Plans Association is a a not-for-profit national association based in Illinois. Through all its various companies, the Delta Dental Plans Association provides coverage o 85 million people.

Below is a list of the companies within the Delta Dental Plans Association. In cases where a single company services multiple states, the associated states are noted.

SOURCE: https://www.deltadental.com/us/en/about-us/delta-dental-member-companies.html