Delta Dental offers dentists the flexibility of participating with one or more of our networks, which serve a variety of commercial, Medicaid, Medicare Advantage, and Medicare and Medicaid dual program members.
Below is a list of our networks and the programs which utilize them.
Delta Dental PPO™
Serves Delta Dental PPO (Standard), Delta Dental PPO (Point-of-Service) and Delta Dental Medicare Advantage™ members.
Delta Dental PPO (Standard)
Delta Dental PPO (Standard) is a preferred provider organization program. Participating dentists treat PPO members and are reimbursed based on their applicable Delta Dental fee schedule amount. Since the PPO program is a popular choice by employers, dentists who participate in this network may see an increase in patients seeking a participating dentist.
FAQs about participating with Delta Dental PPO
Delta Dental PPO (Point-of-Service) combines the characteristics of Delta Dental Premier and Delta Dental PPO into one flexible program. Members who do not go to a participating Delta Dental PPO dentist can still receive treatment from a Delta Dental Premier dentist, but often at a higher out-of-pocket cost.
Medicare Advantage plans are offered through health plan partners and the dental benefits are administered by Delta Dental. Participation in the Delta Dental PPO network includes participation with Medicare Advantage plans administered by Delta Dental. Medicare Advantage members must seek treatment from a participating dentist with their specific network; they do not have out-of-network benefits. A participating dentist cannot balance bill the member for any difference between his or her regular fees and the amount in the program fee schedule.
FAQs about participating with Delta Dental PPO
Delta Dental Premier®
Serves Delta Dental Premier, Delta Dental PPO (Point-of-Service) and Medicare Advantage members
Delta Dental Premier
Delta Dental Premier is a standard fee-for-service program. Dentists submit their usual fees for each service rendered, and participating dentists are reimbursed based on the maximum approved fee. Members are responsible for their copayment and deductible (if any). Participating dentists always receive claim payments directly from Delta Dental and members prefer to seek treatment from a participating dentist because of the lower out-of-pocket costs.
Delta Dental PPO (Point-of-Service) combines the characteristics of Delta Dental Premier and Delta Dental PPO into one flexible program. Members who do not go to a participating Delta Dental PPO dentist can still receive treatment from a Delta Dental Premier dentist, but often at a higher out-of-pocket cost.
Medicare Advantage plans are offered through health plan partners and the dental benefits are administered by Delta Dental. Participation in the Delta Dental Premier network includes participation with Medicare Advantage plans administered by Delta Dental. Medicare Advantage members must seek treatment from a participating dentist with their specific network; they do not have out-of-network benefits. A participating dentist cannot balance bill the member for any difference between his or her regular fees and the amount in the program fee schedule.
FAQs about participation with Delta Dental Premier
Delta Dental EPO™
Serves Delta Dental EPO members.
Delta Dental EPO (exclusive provider organization) is a fee-for-service program, and participating dentists are listed in our closed-panel directory. Members are required to receive services from Delta Dental EPO dentists. Treatment payment is based on the applicable fee schedule and member copayments. Participating dentists receive claim payments directly from Delta Dental and collect only copayments (if any) from Delta Dental EPO members. Delta Dental EPO serves commercial and government program members and is only available in Michigan, Ohio and Indiana.
Medicare Advantage plans are offered through health plan partners and the dental benefits are administered by Delta Dental. Participation in the Delta Dental EPO network includes participation with Medicare Advantage plans administered by Delta Dental. Medicare Advantage members must seek treatment from a participating dentist with their specific network; they do not have out-of-network benefits. A participating dentist cannot balance bill the member for any difference between his or her regular fees and the amount in the program fee schedule.