Delta Dental Plans
The Delta Dental approach to dental insurance is simple – plan options to fit your dental needs backed by one the largest dental networks nationwide and award-winning service. It’s really that simple. Delta Dental individual dental insurance is an affordable way to maintain dental health when you are not eligible for benefits through an employer.Plan highlights include:
- Network access: A wide network of dentists within Illinois to choose from.
- You can visit any dentist, and will almost always pay less out-of-pocket when visiting a Delta Dental Network provider.
- Preventive care focus: Full coverage for routine cleanings, exams, and x-rays.
- PPO option: Most commonly offered as a PPO plan, allowing you to see any dentist but offering better benefits when using in-network providers.
- Cost savings: Lower out-of-pocket costs when utilizing in-network dentists.
- Coverage tiers: Depending on the plan, varying levels of coverage for basic services like fillings and major services like crowns.
- Orthodontic options: Some plans may offer limited orthodontic coverage with waiting periods.
- View the Delta Dental plan brochures for additional details.
Network for greatest savings.
- Over 400,000 access points nationwide
- Over 100,000 unique providers nationwide
- 94% provider persistency
Plan Designs
Delta Dental offers 3 plans: Premium Plan, Elevated Plan, and Base Plan with a choice of a $1,000, $1500 or $2,500 annual benefit. The Dental plans are best for individuals using an Delta Dental network provider. The Premium is best for individuals using a non-network provider. The Delta Dental Network plans provide great discounts for using in-network dentists and prevents any billing “surprises” that dentists outside of the network may charge balance billing (bill the patient for larger amounts than the insurance company pays).Premium Plan
- Designed for someone looking for coverage on all services
- Plan providing coverage beginning day one
- $2,500 maximum per year benefit
Base Plan
- Designed for someone seeking basic protection with preventive care
- Includes cleanings and x-rays covered at 100%
- $1,000 maximum benefit limit per year
Network vs. Non-Network
- All plans offer out-of-network benefits
- Non-network plans provide higher levels of coverage for non-network dentists
- Network plans are cheaper, and are a good way to save money if your dentist is in network
| Premium Plan | Elevated Plan | Base Plan | ||
|---|---|---|---|---|
| Apply | Apply | Apply | ||
| Network | Designed for those who will utilize a Delta Dental Network provider | Freedom to use any dentist, opportunity to utilize a Delta Dental Network provider for additional savings | Designed for those who will utilize a Delta Dental Network provider | |
| Maximum Benefit | $2,500 calendar year benefit | $1,500 calendar year benefit | $1,000 calendar year benefit | |
| Deductible (Basic & Major only)a specified amount of money that the insured must pay before an insurance company will pay a claim. | $100 once per lifetime | $50 per year | $50 per year | |
| Waiting Periods | 12 months type 2 and type 3 | 12 months type 2 and type 3 | 12 months type 2 and type 3 | |
| Enrollment Fees | No | No | No | |
| Premium per month | $88.87 | $53.30 | $34.04 | |
| PREVENTIVE SERVICES (type 1) | ||||
| Plan Pays | Plan Pays | Plan Pays | ||
| Exams (2/year) | 100% | 100% | 100% | |
| Cleanings (2/year) | 100% | 100% | 100% | |
| Bitewing X-rays | 100% | 100% | 100% | |
| Fluoride Treatments (under age 16) | 100% | 100% | 50% | |
| Sealants (under age 16) | 100% | 100% | 100% | |
| BASIC SERVICES (type 2) | ||||
| Plan Pays | Plan Pays | Plan Pays | ||
| Fillings | 50% | 50% | 50% | |
| Simple Extractions | 80% | 50% | 50% | |
| MAJOR SERVICES (type 3) | ||||
| Plan Pays | Plan Pays | Plan Pays | ||
| Oral Surgery | 50% | 50% | Not Covered | |
| X-Rays (panoramic) | 100% | 100% | 100% | |
| Endodontics | 50% | 50% | Not Covered | |
| Periodontics | 50% | 50% | Not Covered | |
| Crowns | 50% | 50% | Not Covered | |
| Bridges | 50% | 50% | Not Covered | |
| Dentures | 50% | 50% | Not Covered | |
| ORTHODONTICS | ||||
| Plan Pays | Plan Pays | Plan Pays | ||
| Orthodontics | Not Covered | Not Covered | Not Covered | |
| Teeth Whitening | 50% | 50% | 50% | |
| DeltaVision Brilliance Plan | DeltaVision Essential Plan | |||
|---|---|---|---|---|
| Apply | Apply | |||
| Network | EyeMed Vision Network | Eyemed Vision Network | ||
| In-Network Copay | In-Network Copay | |||
| Eye Exam | $0 copay | $15 copay | ||
| Contact Lens Exam & Fitting | $0 | $15 | ||
| Frames | $200 allowance then 20% off balance | $150 allowance then 20% off balance | ||
| Contacts (in Lieu of frames) | $200 allowance then 15% off balance | $150 allowance then 15% off balance | ||
| Single/Bifocal/Trifocal Lenses | $0 | $25 | ||
| Lenticular Lenses | $0 | $25 | ||
| Monthly Cost | $22.70 | $14.90 | ||
| Standard Lens Enhancements | ||||
| In-Network Copay | In-Network Copay | |||
| UV Protection Coating | $0 | $16 | ||
| Glass Tints | $75 | Not Available | ||
| Factory Applied Standard Scratch Resistance Coating | $0 | $15 | ||
| Polycarbonate Lenses | $0 | $40 | ||
| Anti-Reflective Coating | $0 | $45 | ||
| Standard Progressive | $0 | $65 | ||
| Additonal Benefits | Members also receive a 40% discount off complete pair eyeglass purchases and a 15% discount off conventional contact lenses once the funded benefit has been used. | Members also receive a 40% discount off complete pair eyeglass purchases and a 15% discount off conventional contact lenses once the funded benefit has been used. | ||
Why do I need dental and vision insurance coverage?
If you are in the market for dental and vision insurance and find yourself asking, “Why do I need it?” consider the advantages to your overall health. Our oral and ocular health can be key indicators in detecting early stages of many health risks and diseases along with preventing many other health issues.Delta Dental understands that your needs are unique
We’re committed to finding you the dental plans that meets your needs. The Delta Dental insurance plans offer affordable coverage with instant free online quotes, coverage for individuals 18+ (including seniors), no online enrollment fees and the Delta Dental network.| Delta Dental insurance plans Include: | Delta Vision insurance plans Include: |
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Network Information
Network for greatest savings.
- Over 400,000 access points nationwide
- Over 100,000 unique providers nationwide
- Delta Dental 65+ insureds have a 41% network utilization with a 31% discount average
- 94% provider persistency
Savings Example
| Procedure | 80th U&C | Network Rate† | Day One Cost | Day One Savings | Year Two Cost | Year Two Savings |
|---|---|---|---|---|---|---|
| Cleaning | $108 | $61 | $0 | 100% | $0 | 100% |
| Filling | $139 | $80 | $52 | 62% | $16 | 88% |
| Crown | $1,117 | $748 | $635 | 43% | $374 | 66% |
| Description of benefits shown based on 60657 zip code. Rates vary by location. Benefits based on Premier dental plan. †MAC/MAB charge. | ||||||
Do I have to use an in-network dentist for your plans?
No, with Delta Dental dental insurance plans, you have the freedom to use any dentist you would like. You do not need to select your dentist from a list of network providers to qualify for benefits and coverage. However, if you purchase a network plan, you have the ability to lower your out-of-pocket costs and receive the greatest savings when you utilize a Delta Dental Network provider.
Can I choose the start date for my plan coverage?
Delta Dental PPO plans have flexible enrollment options — you can choose from four effective start dates when you purchase your plan. The dates are based on the plan purchase date:
- Plans purchased from the first through the 14th of the month have effective date options of the 15th of the current month, the first of the next month, the 15th of the next month or the first of the month after next. For example, a plan purchased on July 3rd can be effective July 15th, August 1st, August 15th or September 1st.
- Plans purchased on or after the 15th of the month have effective date options of the first of the next month, the 15th of the next month, the first of the month after next or the 15th of the month after next. For example, a plan purchased on July 15th can be effective August 1st, August 15th, September 1st or September 15th.
- Plans purchased by the 21st of the month will become effective on the first date of the following month. For example, a plan purchased on June 17th would become effective on July 1st.
- Plans purchased after the 21st will not be effective until the month after the next. For example, a plan purchased on July 25th would not be effective until September 1st.
What is the frequency limit for teeth cleanings?
With Delta Dental plans, you receive two cleanings per year.
PPO plans that cover teeth whitening include both in-office and at-home bleaching treatments. If teeth whitening is covered by the DeltaCare USA plan, only at-home bleaching is covered.
How can I look for in-network dentists?
The Delta Dental PPO Network features:
- Discounted fees, typically 30% below average charges in your community
- Immediate network discounts
- One of the largest nationwide networks with over 400,000 access points and 111,500 unique providers
How long will the enrollment process take?
Enrollment materials will be emailed or mailed to you within 7-10 business days of a completed application, depending on the selection made during the enrollment process.
Which states can I purchase an individual Delta Dental plan?
Delta Dental PPO individual plans are available in AL, CA, DE, FL, GA, IL, IN, LA, MD, MS, MT, NV, NY, PA, TX, UT, WV and DC. DeltaCare USA individual plans are available in CA, FL, MD, NV, NY, PA, TX, UT and DC.
What's the difference between a PPO and DHMO-type plan?
PPO plans help you pay for dental care without offering fixed prices. When you see a dentist in your network, the dentist agrees to charge lower prices, and your plan shares some of the cost. Even if you see a dentist that’s out of your network, Delta Dental will still help pay for covered procedures, although you’ll save less than you would at a Delta Dental dentist. DHMO-type plans have fixed prices for procedures, known as copays. DHMO-type premiums tend to be lower, but you’ll only enjoy coverage at your chosen DeltaCare® USA dentist.
Are braces covered? What about teeth whitening dentures, veneers, etc.?
Delta Dental offers individual dental plans and dental insurance for family members that cover many procedures, including braces, dentures and cosmetic procedures such as teeth whitening. However, not all plans cover all procedures. You may want to shop around for a plan that best suits your current and anticipated needs. Some plans offered by employers may have different benefits than plans available directly from Delta Dental.
Does Delta Dental offer vision coverage?
Yes, Delta Dental offers 2 Individual Vision Plans with to comprehensive and affordable vision coverage..
What is the waiting period for an individual Delta Dental plan?
For basic (e.g., fillings) and major (e.g., root canals, crowns) services, Delta Dental PPO individual plans have a 12 month waiting period, which is a time you must be enrolled for specific services to be covered.⁷
However, diagnostic and preventive care services (e.g., exams, x-rays, cleanings) don’t require waiting periods on any plans.
I haven’t heard back on the status of my application, how do I check the status?
Please call our Administrative Team at (312) 726-6565 or email us at [email protected].
What dental plan should I choose?
Some dental plans may work better for you or your family. Here are a few questions to ask yourself, while reviewing plans:
- Are there waiting periods for certain procedures?
- Does this plan require you to use a network of dentists or can you use any dentist you choose? If the plan has a network, what dentists participate in the plan’s network?
- If I used a dentist outside the plan’s network, what will the benefits be?
- Does the plan charge an enrollment or application fee?
- Is there a deductible on the plan?
- What is the annual maximum?
We can help you to figure out the right plan for you. Download our Plan Comparison Worksheet to help you compare plans.
How do I submit a dental claim?
Dental claims are submitted by dental providers electronically.
Claims can be submitted on your Delta Dental member portal after you register.
Apply Online Now
- Savings for using the Delta Dental network
- Still have the freedom to use any dentist you would like
- Instant free online quotes
- No online enrollment fees