Delta Dental has strived to improve the oral health of Americans around the nation. For those that live in the golden state, Delta Dental of California provides California dental insurance to people on a group and individual basis. With every individual having slightly different needs, you will want to read on to see what plans you qualify for and best suit you!
Delta Dental of California PPO Plan
It is important to note that the Delta Dental PPO plan is only offered to Californians on a group basis. If this plan is not offered through your or your spouse’s employer unfortunately the policy will not be available to you.
Since the PPO has a much larger network of dentists chances are your dentist is a contracted dentist with Delta.
From a coverage standpoint the PPO plan should usually cover preventive care immediately at no charge to you. Preventive care includes your semi-annual teeth cleaning visits and x-rays. Be advised you can have up to a year waiting period for basic services such as fillings and a 2 years waiting period for major services including orthodontics. As a standard, the PPO plan brings with it an annual coverage maximum of $1,000 per member. Sometimes the coverage maximum can be slightly lower or higher depending on the contract with the employer.
Deltacare USA HMO Dental
This California dental insurance plan is offered on an individual basis which means any Californian can apply. This plan is great coverage but the only downside is that you will more than likely not be able to use your regular dentist. The HMO network of contracted dentists is significantly lower than the PPO. If this is not an issue for you this plan is worth the affordable premium of $91 a year.
The plan brings with it and unlimited coverage maximum. You can get as much care as you require! Preventive care for semi-annual teeth cleanings runs $20 per visit. One of the best parts about the Deltacare USA plan is there are absolutely no waiting periods so you may receive care immediately.
For more information on Delta Dental of California fee schedules including more plan details please contact us anytime!
When it comes to choosing the right dental insurance plan in California, there are quite a few things that need to be considered. For instance: Do you urgently require insurance benefits? Are you acquiring a plan mainly to keep up with your preventive care? Do you need an orthodontic treatment? Would you want to continue with your current dentist?
Urgency and Insurance Type
If you are in urgent need of dental benefits, especially right after your effective date, then you may need to acquire an HMO plan. They usually have shorter waiting periods, and you are given all the major services whenever you require them. HMOs typically don’t have benefit maximums.
For instance, if your child urgently requires braces-related help and you don’t have an insurance policy, if you acquire an Anthem Blue Cross stand-alone “Dental Premier Select HMO” or a Delta Dental “Delta Care USA” you’ll get the orthodontic benefit for a reasonably less price if you didn’t have a plan. If you acquire a PPO plan, it is more obvious that there would be a lack of orthodontic benefits, and even if there are, you will need to wait for one complete year.
Moreover, if you require root canals or extraction or a dental crown, there’s a possibility that you could have a three, six or even twelve month waiting period prior to the utilization of those services, plus the final bill could be much higher. For this reason, you should also ensure that you have a high benefit maximum, or you don’t have one at all. Hence it is always better to get HMO coverage if you don’t have coverage and require major benefits urgently.
Preventive Care and Orthodontics
If you are only looking to continue your preventive care, it is better to carry on with the low benefit maximum plans. You can always get an HMO plan in the future if you require major work.
Continuing with your Current Dentist
If you want to continue with the current dentist, but you are unhappy with your insurance coverage, then you should go for a PPO plan. Typically your dentist is not included in an HMO plan, and also in some PPO plans. Therefore, it’s ideal to get services from a local agent, and let him/her search for suitable contracted providers in your area. If your dentist isn’t a part of the networks that you are interested in, then you should seek out a new plan. You should be able to find a good dentist in your area if applying for a PPO plan. On the other hand if you are acquiring an HMO plan, you can still get a good dentist, but you will have less providers to select from.
Dental coverage can be confusing for many people to understand. This can sometimes deter individuals from purchasing a plan. However, it is extremely important to maintain the health of your teeth, otherwise, this can impact your overall health; leading to serious medial problems. Blue Shield of California is constructed to abolish this confusion and ensure that dental coverage is something that everyone can acquire with confidence.
Simplicity:
- You know exactly what you will pay upfront, so there are no hidden fees or surprises. This is extremely helpful when you are factoring your monthly or yearly medical costs into your budget.
- The premiums you do pay out of pocket are reasonable and inexpensive.
- Blue Shield of California’s dental plans are stand alone. This means you don’t have to be on a medical policy to apply for one!
- You will have access to one dental PPO and one dental HMO. This eliminates any confusion or frustration when trying to locate a dentist.
Advantages:
- You have access to a vast network of dentists and dental specialists.
- There is no waiting period for diagnostic and preventative services.
- Orthodontic benefits are available to both adults and children.
- You will be charged a minor – or no deductible – each calendar year, depending if you use a PPO or HMO dentist.
Value:
- After only two preventative visits, your plan is basically paid for. Each visit thereafter will cost you less than if you didn’t purchase any insurance coverage at all.
Ease:
- Blue Shield of California makes your monthly budgeting easier by giving you the option to combine both your medical and dental premiums together into one monthly statement.
We have mentioned PPO and HMO several times, but what exactly are they? These are two different groups available to access medical and dental care.
PPO (Preferred Provider Organization)
With a PPO plan, you are permitted to visit any dentist you wish – and there are over 19,000 in California to choose from. Although there is a list of preferred dentists, you will still receive coverage if you visit one outside of the network. A worthwhile benefit to a PPO is that your out of pocket expenses are lower then you seek out a dentist within our network. Although your premiums through PPO plans are usually more than through an HMO, you have more flexibility and fewer restrictions.
HMO (Health Maintenance Organization)
With an HMO plan, your costs – including premiums and out of pocket expenses – will be lower than if you opt for a PPO. You will also have no deductible on selected services. An HMO is more restrictive than a PPO however. You must visit a dentist that is listed on their directory; you will have a choice of approximately 8,600 dentists. If you instead choose to obtain services from a non-network facility, you will receive no coverage.
Everyone has different and unique needs when it comes to dental care, so the decision between these two plans is ultimately up to the individual.
