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Delta Dental PPO

Frequently Asked Questions


What is the difference between a Delta Dental PPO dentist and one who is not Delta Dental PPO?

A Delta Dental PPO dentist is contracted with ODS to provide dental care to you and your covered dependents. If you receive care from a dentist who is not a Delta Dental PPO dentist, out-of-network coverage applies. A Delta Dental PPO dentist has also agreed to submit any necessary claims to ODS.

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What dentist can I see?

For in-network benefits, you must receive care from a dentist from the Delta Dental PPO Directory. For a list of participating Delta Dental PPO dentists, view our directory.

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Can I see a specialist with my plan?

Specialist services are a covered benefit under most plans. For a list of participating Delta Dental PPO specialists, view our directory. If you receive care from a specialist who is not a Delta Dental PPO dentist, out-of-network coverage applies. You may want to have the specialist submit a preauthorization to determine how much of a benefit you can expect to receive.

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How can I find out what my remaining benefits are for this current benefit year?

Contact Customer Service, and we will review your claims history to determine how much you have remaining.

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What are the benefits and covered services under my dental plan?

Refer to your member handbook for general information. If you have further questions about a specific service, contact customer service.

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What do I do if I have a dental emergency and I'm out of town?

Most of our plans allow you to see any licensed dentist. Out-of-network coverage levels will apply. Refer to your Member Handbook for any specific limitations.

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How long are my children covered under my dental plan?

Refer to your Member Handbook for the specific age limits under your plan.

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My former employer is allowing me to pay for continued insurance coverage on my own. How long will my COBRA plan be effective?

The length of time COBRA is offered is dependent upon the employer. You can contact the employer or the 3rd party administrator that handles the plan.

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What does the term "least costly" mean?

If a tooth can be restored with a procedure that is less expensive than the procedure rendered, benefits paid will be based on the procedure that costs less.

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