Notice
Change Healthcare announced a breach of HIPAA privacy and is reaching out to individuals whose personal information may have been compromised. Although this incident does not involve Delta Dental of New Jersey or Connecticut, Change Healthcare is a vendor we used and we are providing this information to help our members who might be affected.
Your Smile, Your Choice
Delta Dental PPO™ & DeltaCare® USA
You can choose between two dental plans from Delta Dental. Either way, you’ll get reliable dentist networks and affordable preventive care. Your options are:
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1 In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan.
2 In WY, you do not need to select a primary care dentist, but you must visit a network dentist to receive benefits. In the following states, you can maximize your savings when you visit a network dentist, although you may visit any licensed dentist and receive out-of-network coverage: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT. Refer to your plan booklet for details about your out-of-network benefits.
3 Refer to your plan booklet for more information about covered services, deductibles and maximums.
4 In AK, CT, ND and SD, you have an out-of-network calendar year maximum of $500 when you visit an out-of-network dentist.
5 Except in Texas; please refer to your plan booklet for details.
6 Most services not performed by your primary care dentist must be authorized by Delta Dental. In some states, specialty care benefits are only available for services performed by an in-network specialist. Refer to your plan booklet for details.
7 In the following states, you can change your dentist any time without contacting Delta Dental: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT, WY.
8 You may have to complete a claim form if you visit an out-of-network dentist, such as for limited emergency treatment or in the following states: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT.
Delta Dental PPO1This preferred provider plan offers the convenience and flexibility of visiting any licensed dentist, anywhere. Covered services are paid based on a percentage — if, for example, fillings are covered at 80%, you pay the remaining 20%. Get the most plan value by choosing a Delta Dental PPO dentist. PPO network dentists complete claim forms for you and can help advise you on questions regarding your share of the payment. |
DeltaCare USAUnder this HMO-type plan, you’ll have your choice of skilled primary care dentists from the DeltaCare USA network. Select a primary care dentist, who will then coordinate any needed referrals to a specialist.2 Covered services provided by your DeltaCare USA dentist have preset copayments (dollar amounts), which are listed in your plan booklet. There are no maximums or deductibles.3 |
Compare Plan Features
| Delta Dental PPO | DeltaCare USA | |
|---|---|---|
| Can I go to any dentist? | You can visit any licensed dentist to receive coverage, but you’ll save the most at an in-network dentist. | You must select a DeltaCare USA primary care dentist and visit this dentist to receive benefits.2 |
| What procedures are covered? | Your plan covers a wide range of services, with no exclusions for most pre-existing conditions. Preventive care, like routine cleanings and exams, is offered at low or no cost. | Your plan covers over 300 procedures, with no exclusions for most pre-existing conditions. Preventive care, like routine cleanings and exams, has low or no copayments. |
| Are there deductibles and maximums? | Yes, most plans have an annual deductible and maximum. | No, there are no annual deductibles or maximums.4 |
| Am I covered for treatment I began under a different employer-sponsored dental plan? | Coverage is provided only for treatment started and completed after your effective date. Orthodontic treatment may be an exception to this rule. | Coverage is provided only for treatment started and completed after your effective date.5 Orthodontic treatment may be an exception to this rule. |
| What if I started orthodontic treatment under my previous dental plan? | Typically, Delta Dental pays the remaining benefit not paid by your prior dental plan. | You are responsible for the copayments and fees subject to the provisions of your prior dental plan. |
| What happens if I need to see a specialist? | You do not need a referral from your dentist. | Contact your DeltaCare USA primary care dentist to coordinate your referral.6 |
| What is my out-of-area coverage? | You can visit any licensed dentist. | You have a limited benefit to go out of network for emergency care. |
| How do I change my dentist? | You can change your dentist at any time without contacting us. | You can change your selected or assigned primary care dentist online or by telephone.7 |
| Do I need to fill out claims? | If you visit a Delta Dental dentist, the dental office will file the claim for you. If you go to a non–Delta Dental dentist, you may have to submit the claim yourself. | There are generally no claim forms under your plan.8 |
Download PDF1 In Texas, Delta Dental Insurance Company provides a dental provider organization (DPO) plan.
2 In WY, you do not need to select a primary care dentist, but you must visit a network dentist to receive benefits. In the following states, you can maximize your savings when you visit a network dentist, although you may visit any licensed dentist and receive out-of-network coverage: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT. Refer to your plan booklet for details about your out-of-network benefits.
3 Refer to your plan booklet for more information about covered services, deductibles and maximums.
4 In AK, CT, ND and SD, you have an out-of-network calendar year maximum of $500 when you visit an out-of-network dentist.
5 Except in Texas; please refer to your plan booklet for details.
6 Most services not performed by your primary care dentist must be authorized by Delta Dental. In some states, specialty care benefits are only available for services performed by an in-network specialist. Refer to your plan booklet for details.
7 In the following states, you can change your dentist any time without contacting Delta Dental: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT, WY.
8 You may have to complete a claim form if you visit an out-of-network dentist, such as for limited emergency treatment or in the following states: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT.
Delta Dental of New Jersey is a part of Delta Dental Plans Association. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories.
