Delta Dental PPO Plus Premier offers extensive national coverage by combining two of Delta's national networks. Delta Dental PPO network gives you access to over 104,000 dentist locations and Delta Dental Premier is the largest dental network in the country with over 186,000 dentist locations. Three out of four dentists nationwide and 96% of Massachusetts dentists participate in this network. The plan works much like a traditional fee-for-service plan, with in-network and out-of-network benefit levels. Participating dentists have agreed to accept negotiated fees for their services, which mean lower out-of-pocket cost to you. There is no balance billing when you visit a participating dentist.
Delta Dental PPO Plus Premier Plan also provides coverage for services received from non-participating dentists, however they may balance bill you. You will be responsible for the difference between the non-participating maximum plan allowance and the full fee charged by the dentist. Refer to your subscriber certificate for more information.
The plan provides benefits according to our plan schedule. There is a $1,500 maximum benefit per person per calendar year.
Under the DeltaCare DMO, a personal dentist must be chosen from a list of participating dentists. Coverage is provided for services performed by a DeltaCare dentist as well as limited coverage for out-of-network services.
It is not necessary to submit claim forms, nor are there any deductibles to be met, if services are performed by a DeltaCare dentist. The plan provides benefits according to a preset copayment schedule.
- Nonexempt Staff Rates (PDF)
- Exempt Staff/Faculty/PostDoc Rates (PDF)
- Same-Sex Domestic Partner Nonexempt Rates (PDF)
- Same-Sex Domestic Partner Exempt/Faculty/PostDoc Rates (PDF)
- DeltaCare Plan Description (PDF)
- DeltaCare Subscriber Certificate (PDF)
- Delta Dental PPO Plus Premier Plan Description (PDF)
- Delta Dental PPO Plus Premier Subscriber Certificate (PDF)