Delta Dental Insurance in Katy

Three Delta Dental names patients mix up

Delta Dental PPO is a preferred-provider plan. You can see a wide range of dentists, and the plan's allowance is tied to the PPO network. Delta Dental Premier is a different network with its own fee arrangement. DeltaCare, sometimes called DeltaCare USA, is a dental HMO: you pick or are assigned a primary office, and another office usually cannot bill that plan.

Dentality Family Dentistry accepts Delta Dental. We do not treat those three products as the same card. When you schedule, tell us which name is printed under the logo. If it says DeltaCare and lists a facility, we will confirm whether this office is the one that can see you.

Tell us whether the card says PPO, Premier, or DeltaCare when you book. Those three words change the claim, and correcting it after the visit is harder than reading the card the day before.

What Delta Dental plans tend to cover

PPO and Premier contracts still vary by employer, but the shape is familiar. Preventive care is the most generous category. Basic care is next. Major care — crowns, bridges, dentures — usually pays a smaller percentage and may have a waiting period on newer policies. Implants and adult orthodontics are the benefits we never assume. Some Delta groups cover them, some exclude them, and some cover only part of the work.

The annual maximum is a dollar cap on what Delta Dental pays in the benefit year, not a cap on what the dentist can recommend. Once the maximum is used, further treatment is your cost until the plan renews. We will tell you where you stand before a large visit.

Delta Dental of the state printed on your card is the company that processes the claim, even if you are sitting in a Texas office. We send the claim to that company. You do not forward it yourself.

What to bring

A DeltaCare assignment lists a primary office. If that office is not this one, we will say so on the phone. A PPO card does not have that restriction, which is another reason the product name matters.

• The Delta Dental ID card showing PPO, Premier, or DeltaCare
• Subscriber ID and date of birth
• The state or employer group if more than one Delta plan could apply
• Any pretreatment estimate Delta Dental already issued

How we file

We send the claim to the Delta Dental company on the card. Delta Dental plans are administered by different member companies, and the address on the card is how we pick the right one. You do not mail the claim. If Delta Dental asks for films, we upload them.

We review the patient share with you first. Other accepted plans are listed on the insurance and financing page.

Implant language on Delta Dental contracts is inconsistent. Some groups cover the implant body, some cover only the crown that goes on it, and some cover neither. We read your group before we talk about scheduling an implant.