Delta Dental Plans for Seniors

Delta Dental Coverage Options

Delta Dental is one of the largest dental insurance carriers in the country.2 Delta’s individual (meaning, insurance not tied to an employer or the government) PPO plans are available in the following states:

• Alabama
• California
• Delaware
• Florida
• Georgia
• Louisiana
• Maryland
• Mississippi
• Montana
• Nevada
• New York
• Pennsylvania
• Texas
• Utah
• West Virginia
• Washington, D.C.

DeltaCare USA, which are Delta’s individual HMO plans, are available in:

• California
• Florida
• Maryland
• Nevada
• New York
• Pennsylvania
• Texas
• Utah
• Washington, D.C.

Delta Dental plan availability and pricing vary depending on your location, age, and health status. To find Delta Dental plans in your area, visit the Delta Dental website and enter your ZIP code in the search box. Delta Dental provides plan information on the main website or will redirect you to the Delta Dental independent network in your state. Delta Dental also partners with AARP to offer PPO and HMO plans to AARP members with similar coverage details and premiums as Delta Dental’s individual plans.

» Related Resource: 2024 Guide to AARP Membership

Depending on where you live, your Delta Dental plan might have a “graduated benefits” structure, which means your dental benefits might increase over time. With Delta Dental of Tennessee’s Advantage Plans, for example, 25 percent of basic dental services are covered in the first year of coverage. After that, it covers 50 percent in years two and three, and then 80 percent in year four and beyond.3 For comparison, Cigna has graduated benefits as well, with benefits increasing 10 percent per year and up to 90 percent coverage for certain services after four years.

In many states (AL, CA, DE, FL, GA, LA, MD, MS, MT, NV, PA, TX, UT, and DC), you’ll be charged a small (likely $10), nonrefundable administrative fee for processing your application. To keep out-of-pocket costs down, Delta Dental recommends policyholders have their dentists submit a pretreatment estimate for any procedure expected to cost more than $300.

Here’s a sampling of Delta Dental plans available to seniors in Boston, Massachusetts:

Delta Dental PPO Value for Seniors

This affordable plan might be a great option for older adults who have enjoyed good dental health over the course of their lives and who have the financial ability to cover unexpected out-of-pocket costs for major work if needed.

The PPO Value for Seniors plan keeps it simple with no deductibles or co-pays, and there’s no waiting period for preventive care. Plan details can vary depending on where you live. And keep in mind you’ll need to see an in-network dentist for virtually all your care, so finding a good in-network dentist in your area who is accepting new patients will be very important. (For comparison, Aetna PPO plans appear to offer more flexibility regarding out-of-network providers and might pay a portion of those costs.)

Many PPO Value for Seniors plans provide some coverage for services such as crowns, bridges, dentures, implants, and root canals. By contrast, Aetna does not provide any coverage for dental implants. But in general, it’s a good idea to contact Delta Dental customer service representatives beforehand to get a clear picture of what services are covered and what your out-of-pocket costs might be.

Highlights of the Delta Dental PPO Value for Seniors Plan:

• Low-cost plan for people over 65 (currently $21.43 a month)
• Access to more than 6,500 dentists nationwide
• No deductibles, co-pays, or annual benefits maximum
• 100 percent coverage for diagnostic and preventive care (two cleanings and two exams per year)
• No waiting period for preventive care
• Some plans might have coverage for crowns, bridges, dentures, implants, and root canals
• No out-of-network coverage other than for diagnostic or preventive services
• Two surface silver fillings: $108
• Crowns, endodontic services (such as root canals), periodontal care (such as periodontal scaling and planing), oral surgery, implants, and dentures available for discounted fees from participating dentists

Delta Dental Total Choice PPO 2000

A comprehensive PPO plan can be a good choice for older adults who are likely to have significant dental care costs each year, as long as the premiums aren’t too steep.

At around $70 per month for a 60-year-old, premiums for Delta Dental Total Choice PPO 2000 are almost twice as much as Aetna Dental Direct’s Preferred PPO plan, for example. But Delta Dental Total Choice PPO 2000 covers considerably more — possibly 100 percent coverage for root canals and oral surgery — while the Aetna Preferred PPO plan might cover just half the cost.

This Delta Dental plan also has a higher benefits maximum per year, at $2,000, compared with Aetna Dental Direct Preferred PPO’s cap of $1,250. As with Aetna Dental Direct, preventive care should cost nothing.

Highlights of the Delta Dental Choice PPO 2000 Plan:

• Highest level of coverage among Delta Dental plans, with 100 percent coverage for exams, X-rays, and cleanings, and simple restorative services such as fillings
• Monthly premiums: $73.27 a month and up
• Can choose from more than 3,500 dentists
• $50 annual deductible
• $2,000 annual benefits maximum
• Coverage of crowns, fillings, periodontal scaling and root planing, root canals, and oral surgery at 100 percent
• Coverage for dentures at 60 percent
• Six-month waiting period for basic restorative care, such as fillings
• Twelve-month waiting period for major restorative care, such as crowns

Delta Dental Individual and Family DeltaCare (HMO)

With monthly premiums under $30 per month, this plan is an affordable option that provides no-cost preventive dental care, such as X-rays and cleanings. It also offers low co-pays for services such as fillings and periodontal scaling and root planing. Because it’s an HMO, you must choose a primary care dentist in Delta’s network. Whether DeltaCare is right for you depends a lot on the provider network in your area. The DeltaCare plan won’t cover out-of-network specialists except in certain emergency situations.

DeltaCare has an annual benefits cap of $1,000, which is fairly low if you need major dental work in the next year. (Similarly, UnitedHealthcare’s DentalWise Basic and DentalWise Max 1000 cap annual benefits at $1,000.) With this plan, your co-payments are paid directly to your dentist so there’s no reimbursement paperwork to fill out. Because you pay these co-payments for most services, there’s no deductible that needs to be paid before coverage begins.

Here are a few examples of what some services might cost with this plan:

• Extractions: $30 and up
• Periodontal scaling and root planing, four or more teeth, per quadrant: $69
• Two surface silver fillings co-pay: $42

Be aware that with this plan, there is no coverage for lost or stolen crowns, bridges, or full or partial dentures. There is some coverage for dentures and partials, up to one set per arch once every five years provided the existing set is no longer serviceable.

Delta Dental Patient Direct

This isn’t an insurance plan per se, but Delta Dental’s Patient Direct plan can be a great option for seniors who can’t or prefer not to pay monthly premiums for dental insurance. These types of plans can cut out-of-pocket costs for needed dental work, which, unfortunately, can be high even if you have dental insurance.

Insurance companies negotiate lower rates with dentists in their network to offer these discount programs. Card holders then have access to a broad range of dental services and procedures at lower costs than if they were paying out of pocket. Because Patient Direct costs less than $9 a month (but is paid annually), this might be a good choice for older adults whose teeth and gums are pretty healthy. It could help them ease the financial burden if they do need major dental work or want help paying for dentures or bridges.

» FYI: 13 Things That Are Free for Seniors

Aetna’s similar discount card, Aetna Vital Savings Dental Discount Card, costs $8 per month, or you have the option to pay $75 up front for the entire year.

Like HMO plans, Delta Dental Patient Direct only offers discounts with dentists in their network, so it’s important to make sure you can find an in-network provider that is convenient to you and accepting new patients. Keep in mind the Delta Dental Patient Direct network is smaller than the network provided for Delta Dental insurance holders. Also remember with Patient Direct, you have to pay for checkups and cleanings, the cost of which Delta Dental estimated at around $120 in 2018.4

Highlights of Delta Dental Patient Direct:

• More than 1,800 participating locations
• Dental providers must be in-network
• Checkups, fillings, and crowns from 15 percent to 45 percent off

Delta Dental Plans for Seniors Costs

As mentioned, costs for Delta Dental plans vary depending on where you live, along with other factors, such as your age. As an example, here are the three Delta Dental plans available to a 65-year-old in Florida. Note that Delta Dental PPO Value for Seniors is unavailable in Florida, and all three Florida plans have a one-time nonrefundable enrollment fee of $10.

By contrast, a 65-year-old man in Florida can get similar coverage with Cigna Dental 3000/100 for $33 a month, with a deductible of $100 and a $3,000 annual maximum in the first year. Cigna might cover 60 percent in the first year (and higher percentages of the cost in subsequent years) of some basic services, such as fillings, periodontal scaling and root planing, and basic oral surgery.5 Delta Dental, on the other hand, provides 50 percent coverage for these services. Although Delta’s deductible is only $50, this plan has an annual maximum of $2,000.

Delta Dental’s PPO Premium plan also costs a bit more than the Aetna Dental Direct Preferred PPO plan, which provides similar coverage (50 percent of major dental services) for about $42 a month for a 60-year-old woman in Florida.

Another thing to note about Delta Dental’s PPO Premium plan: It lists whitening as a partially covered service, after a waiting period. This isn’t a typical benefit, as most insurance companies consider teeth whitening to be a cosmetic service. Check your individual policy for specific coverage information in your area. Some Delta Dental affiliates note whitening services are usually not covered.

Delta Dental Medicare Advantage Plans With Dental Coverage

Delta Dental partners with Medicare Advantage (MA) programs to provide dental coverage included in MA plans in the following states:

• Alabama
• Arizona
• California
• Colorado
• Florida
• Hawaii
• Idaho
• Illinois
• Nevada
• New Mexico
• North Carolina
• Ohio
• Oregon
• Pennsylvania
• Texas
• Utah
• Washington

Coverage and plan options vary depending on where you live. For one example, the company providing Delta Dental Medicare Advantage plans in California only covers exams, cleanings, fluoride treatments, and X-rays. All service providers need to be in-network, as there’s no coverage for out-of-network dental care.

» Related Resource: Best Medicare Advantage Plans With Dental Coverage

Another example: Floridians on a BayCare Medicare Advantage Plan are automatically enrolled in a basic Delta Dental plan with a $2,000 annual benefits limit for $0 per month. They also have the option, during enrollment periods, to instead pay $49 per month for comprehensive dental coverage, with a $4,000 annual maximum, that could provide full coverage for fillings, crowns, root canals, and dentures (every five years), depending on your circumstances.6

How to Purchase a Delta Dental Plan

Shopping for a plan online is easy. Just select the plan you’d like, then enter your contact information and answer a few questions, such as whether you’re working with an insurance broker. Then you’ll be asked for your payment information and whether you would like to sign up for auto pay. (If you don’t want to do auto pay, make sure you pay your premiums on time. Missing a payment might prompt the company to restart your waiting period for services or cancel your insurance altogether.)

Alternatively, you can call Delta to speak with an insurance sales representative. You might consider calling so you can ask any questions you have about the policy while signing up.

Delta Dental Reviews

Some online reviewers wrote they’re happy with their Delta Dental insurance plans, particularly with the PPO plans. One reviewer liked that some adult orthodontic work was covered in their plan.

But Delta has also received a fair amount of criticism in different areas. Complaints include difficulty getting crowns covered or canceling their policy. Some expressed frustration about getting a bill even for X-rays because Delta Dental removed their dentist from their provider network.

Several reviewers said they were given inaccurate information over the phone about what and or how much Delta would cover for dental services. Others have mentioned Delta’s database of network providers was out of date and inaccurate. Others expressed frustration with billing and claims. One reviewer wrote there were few specialists in her Delta HMO network so they had a long drive to a dentist, despite living in a large metropolitan area.

Final Thoughts

Delta Dental has a 60-year history of providing insurance to Americans with availability in all 50 states. Certain plans have more limited availability, though. We appreciate that there’s no waiting period or deductible required before you can see a dentist for checkups and cleanings. Delta’s graduated benefits mean your coverage for dental services increases over time. Other pluses of Delta Dental are its affordable senior-specific dental plans and discount card program.

Premiums vary across states, regions, and among plans, so it’s a good idea to read your individual policy information carefully. Note any waiting periods for dental services. For example, while Delta Dental’s PPO Basic plan has very low monthly premiums, there’s a six-month waiting period for fairly simple work, such as fillings and extractions.

It’s also a good idea to consider which dental services are most important to you when choosing an individual dental plan best for your needs as a senior. For example, many companies, such as Delta Dental, have a 12-month waiting period before providing any coverage for dentures, but they can vary in how much they’ll cover after the waiting period ends.