Delta Premier Dental Insurance is a managed fee-for-service dental plan offered by Delta Dental, known for having the largest network of dentists nationwide. This plan provides access to a vast network where dentists agree to contracted fees, helping members save money on dental care. Delta Premier is designed to offer flexibility, allowing members to visit any licensed dentist, including specialists, with the assurance that they will not be charged more than the agreed fees. It is ideal for individuals and families seeking broad access to dental providers and comprehensive coverage for a variety of dental needs, including prevention and treatment of gum inflammation and gum disease.
Delta Premier Dental Insurance Plan Types
Delta Premier is part of Delta Dental’s suite of dental insurance plans, which also includes PPO and PPO Plus Premier plans. Specifically, Delta Premier operates as a managed fee-for-service plan with the largest dentist network. Unlike PPO plans that emphasize a preferred provider network, Premier allows members to see any licensed dentist but encourages staying within the Premier network for cost savings. The Premier network includes about 95% of dentists in many states, making it easy to find in-network care almost anywhere.
Key Plan Types Related to Delta Premier:
Delta Dental Premier: Fee-for-service plan with the largest dentist network.
Delta Dental PPO: Preferred provider organization with a smaller network but deeper discounts.
Delta Dental PPO Plus Premier: Combines both networks for broader access and benefits.
Delta Premier Dental Insurance Advantages
Delta Premier offers several advantages:
Largest Dentist Network: Members have access to the largest network of dentists nationwide, with around 75% of dentists participating, making it easier to find in-network care.
Flexibility: Members can visit any licensed dentist, including specialists, and can change dentists anytime without notification.
Cost Control: Dentists in the Premier network agree not to bill more than Delta Dental’s approved amount, preventing surprise charges and reducing out-of-pocket costs compared to non-Delta dentists.
Coverage Anywhere: Members can receive dental care anywhere in the U.S. and even internationally, with out-of-network benefits applying.
Simplified Claims Process: Delta Dental dentists file claims and accept payment directly from Delta Dental, minimizing paperwork for members.
Preventive Care Focus: Coverage includes preventive services like cleanings and exams, which are essential for managing and preventing gum inflammation and gum disease.
Delta Premier Dental Insurance Coverage
Delta Premier covers a wide range of dental services, categorized as preventive, basic, and major services, with specific coinsurance rates and deductibles:
Preventive and Diagnostic Services: Includes exams, cleanings, X-rays, sealants, and fluoride treatments. These services are typically covered at 80% of the usual, customary, and reasonable (UCR) fees with no deductible, encouraging regular dental visits to prevent gum inflammation and gum disease.
Basic Services: Such as fillings, extractions, oral surgery, endodontics (root canals), and periodontics (gum disease treatment). Coverage is generally around 80% of UCR fees after deductibles.
Major Services: Including crowns, implants, dentures, and prosthodontics, usually covered at 50% of UCR fees with applicable deductibles.
Orthodontic Services: Some plans include orthodontic benefits with lifetime maximums, which may be relevant for correcting bite issues that can affect gum health.
Members are responsible for deductibles, coinsurance, and any amounts exceeding plan maximums. Preventive services usually do not count toward the deductible or annual maximum, promoting early care.
Delta Premier Dental Insurance Related Costs
Costs associated with Delta Premier include:
Premiums: Monthly payments vary by plan and location but tend to be moderate given the extensive network and coverage.
Deductibles: Typically apply to basic and major services but not preventive care. For example, a common deductible might be $50 per member annually.
Coinsurance: Members pay a percentage of the cost for covered services, such as 20% for preventive and basic services and 50% for major services.
Annual Maximums: Plans often have an annual maximum benefit limit, commonly around $1,500 per member, after which the member pays 100% of additional costs.
Out-of-Network Costs: Visiting dentists outside the Premier network may result in higher out-of-pocket expenses since those dentists are not bound by contracted fees and may bill at full rates.
Delta Premier Dental Insurance Pros and Cons
| Pros | Cons |
| Largest dentist network nationwide, making it easy to find in-network care. | Higher premiums compared to some PPO or DHMO plans due to extensive network and coverage. |
| Flexibility to see any licensed dentist, including specialists, without referrals. | Out-of-network visits can lead to higher out-of-pocket costs since dentists may charge full fees. |
| Preventive care is well-covered, helping manage gum inflammation and prevent gum disease. | Deductibles and coinsurance apply to many services, which can add to costs for extensive treatments. |
| Claims are filed by dentists directly, reducing paperwork for members. | Annual maximum limits may restrict coverage for costly procedures like implants or orthodontics. |
| Nationwide coverage, including out-of-state and international care with out-of-network benefits. | Some major procedures may have waiting periods depending on enrollment timing. |
Conclusion
In summary, Delta Premier Dental Insurance is a comprehensive dental plan offering broad access to a large network of dentists with flexible coverage options. It is particularly beneficial for those who want the freedom to choose any dentist and seek extensive preventive and treatment services, including care for gum inflammation and gum disease. However, members should be mindful of deductibles, coinsurance, and annual maximums when budgeting for dental care costs. This plan balances flexibility, coverage, and cost control, making it a strong choice for many individuals and families.
