Delta Dental 101
Understanding Your Dental Benefits

We’re here to help!

Dental insurance can be confusing. This guide will help you better understand how dental plans work so you can get the most from your coverage.

To get started, choose from one of the topics listed below.


How to Buy a Dental Plan


If your employer doesn’t offer a dental plan, if you are a part-time or seasonal worker, if you are retired, or if you just choose to purchase on your own, we have a dental plan that is likely to fit your unique dental needs and budget. Let's get you started!

Evaluate Your Needs

Everyone has different health needs – including you and the dependents (often family members) covered under your plan. Individuals with risk factors, such as tobacco use or prior cavities, will have different needs. And families with children will likely need to consider different dental care needs than an older couple or a young individual.

Do you relate to any of the below?

First-time buyers

You usually face fewer oral health challenges, but it’s still important to have a dental plan in case unexpected dental work is needed. Learn more about why dental is essential, especially as a millennial.

Head of household

You are more likely to have a family, or to be considering starting one soon. You will need a plan that covers you, your spouse and your children. Learn more about dental plans that suit the specific needs of families.

Retiree

You may have retired from your job, but it’s important not to retire from your dental benefits. Learn more about how you can continue your dental benefits hassle-free when you retire!

Know the Plan’s Value

Not only do dental benefits save you money by lowering the cost of dental treatments and sharing expenses with the carrier, but you can save even more money by using an in-network dentist.

Bonus: Studies have shown that people who have dental benefits are more likely to go to the dentist, and people who visit the dentist regularly are more likely to report a healthy mouth and better overall well-being than those who don’t.

Compare Coverage

What plan best suits your financial needs? Look at the deductible and copays for varying levels of care, as well as the different premiums.

Understand Enhanced Benefits

In addition to typical coverage, some carriers offer enhanced benefits. Enhanced benefits provide extra oral health care for people who may benefit from additional dental services due to specific health conditions. For example, people with diabetes, heart conditions or oral cancer may benefit from additional cleanings to help maintain their overall health. Some dental plans may also include add-ons, such as orthodontic benefits.

Four Things to Think About When Selecting Dental Insurance

Dental Benefits Save You Time & Money

How to Buy a Dental Plan


If your employer doesn’t offer a dental plan, if you are a part-time or seasonal worker, if you are retired, or if you just choose to purchase on your own, we have a dental plan that is likely to fit your unique dental needs and budget. Let's get you started!

Evaluate Your Needs

Everyone has different health needs – including you and the dependents (often family members) covered under your plan. Individuals with risk factors, such as tobacco use or prior cavities, will have different needs. And families with children will likely need to consider different dental care needs than an older couple or a young individual.

Do you relate to any of the below?

First-time buyers

You usually face fewer oral health challenges, but it’s still important to have a dental plan in case unexpected dental work is needed. Learn more about why dental is essential, especially as a millennial.

Head of household

You are more likely to have a family, or to be considering starting one soon. You will need a plan that covers you, your spouse and your children. Learn more about dental plans that suit the specific needs of families.

Retiree

You may have retired from your job, but it’s important not to retire from your dental benefits. Learn more about how you can continue your dental benefits hassle-free when you retire!

Know the Plan’s Value

Not only do dental benefits save you money by lowering the cost of dental treatments and sharing expenses with the carrier, but you can save even more money by using an in-network dentist.

Bonus: Studies have shown that people who have dental benefits are more likely to go to the dentist, and people who visit the dentist regularly are more likely to report a healthy mouth and better overall well-being than those who don’t.

Compare Coverage

What plan best suits your financial needs? Look at the deductible and copays for varying levels of care, as well as the different premiums.

Understand Enhanced Benefits

In addition to typical coverage, some carriers offer enhanced benefits. Enhanced benefits provide extra oral health care for people who may benefit from additional dental services due to specific health conditions. For example, people with diabetes, heart conditions or oral cancer may benefit from additional cleanings to help maintain their overall health. Some dental plans may also include add-ons, such as orthodontic benefits.

Four Things to Think About When Selecting Dental Insurance

Dental Benefits Save You Time & Money

Dental Networks Explained


One of the best ways to get the most value out of your dental coverage is to visit a dentist who participates in your plan’s network. In the dental insurance industry, we refer to these dentists as participating or in-network dentists. In-network dentists agree to provide you services at discounted rates and file all claim forms for you.

We offer a few dentist networks for accessing care. However, the majority of our plans come with access to our Delta Dental PPO℠ or Delta Dental Premier® network. The network you should use depends on your plan’s coverage.

How to Find a Delta Dental Participating Dentist:

Dentists who have agreed to provide treatment to patients covered by a Delta Dental policy are called ‘participating’ dentists. For your policy, participating dentists may be either Delta Dental Premier® or Delta Dental PPO℠ dentists.

Delta Dental Premier® Dentists:

Delta Dental Premier® dentists have agreed to accept the Maximum Allowable Fees in our Delta Dental Premier® provider agreement for the services they provide.

Delta Dental PPO℠ Dentists:

Delta Dental PPO™ dentists have agreed to accept the Maximum Allowable Fees in our Delta Dental PPO™ provider agreement. The Delta Dental PPO™ Maximum Allowable Fees are typically less than the Delta Dental Premier® network. Because of this, selecting a Delta Dental PPO™ dentist may be a more cost-effective option for you.

If you select either a Delta Dental Premier® or Delta Dental PPO™ dentist, they will complete and submit claim forms, and receive payment directly from Delta Dental of Minnesota on your behalf. You will not be charged more than the participating dentist’s Maximum Allowable Fee. You will be responsible only for the coinsurances, deductibles, any amount over the plan annual maximum, and for any care you choose to receive outside the covered services.

Example:

This chart shows a comparison of how your out-of-pocket costs are impacted by your selection of a Delta Dental PPO™ dentist, a Delta Dental Premier® dentist, or a dentist who is not participating in one of our networks (also referred to as non-participating or out-of-network dentist).

Delta Dental of Minnesota’s payment for covered services in this example is 50%.

Type of Provider Provider Submitted Procedure Cost Maximum Allowable Fee What Delta Dental Pays Your Out of Pocket Cost
Delta Dental PPO™ dentist $100 $80 $40 $40
Delta Dental Premier dentist $100 $90 $45 $45
Non-Participating dentist $100 $70 $35 $65**

**Note: We have no control over the fees a non-participating dentist may charge. You are responsible for paying the difference between Delta Dental of Minnesota’s allowable fee and the fees charged by the non-participating dentist.

To check if your dentist is a participating dentist, or to find a new participating dentist, visit DeltaDentalMN.org/find-a-dentist. We highly recommend using the website for network information. You can search for providers by ZIP code, address or by your current location. You can also search by clinic or provider name.

Importance of Visiting an In-Network Dentist

Delta Dental PPO℠ network

If you have a Delta Dental PPO™ plan, then your plan is designed to give you the greatest opportunity for savings when you visit a Delta Dental PPO™ network dentist.

Many PPO™ plans also come with access to the Delta Dental Premier® network. Because our Premier® network is slightly larger than our PPO™ network, it acts like a safety net to ensure you can access in-network care. It’s kind of like a network within a network.

If you have a PPO™ plan and visit a Delta Dental Premier® dentist, you will not maximize your out-of-pocket cost savings.

Pay special attention to your coverage and network before you seek dental care. Some plans are PPO™-only plans. If you have a PPO™-only plan, your coverage only works when you receive care from an in-network dentist.

Delta Dental Premier® network

If you have a Delta Dental Premier plan, you get the most from your coverage when you visit a Delta Dental Premier network dentist. You may also seek care from a Delta Dental PPO™ dentist.

Whether you have a PPO™ or Premier® dental plan, accessing in-network dental care is easy. More than 4 out of 5 dentists in Minnesota participate in one or both networks.

Find a Dentist near you!

Not sure what network is offered by your dental plan? The network your dental plan utilizes is listed on your ID card and in your benefit booklet. You may also call customer service.

For more useful information like this, check out the Delta Dental of Minnesota Blog.

Learn More

Choosing the Right Dentist for You


Whether you’ve moved to a new city, switched insurance providers, or are just looking for a new dentist, it can feel tricky to know where to start. Here are a few key factors to consider when starting your decision-making process:

Your Network

Seeing an in-network dentist will save you the most out-of-pocket costs.

There are easy ways to make sure the dentists you’re looking at are a part of your dental network – you can start with our Find a Dentist tool, call the dental office to make sure, or call the number on the back of your ID card. Whether you’re searching online or talking to a customer service representative, understanding your options will help you narrow the pool from every dentist in the city to a manageable list.

Click here to use the Find-a-Dentist Tool.

Not sure what network is offered by your dental plan? The network your dental plan utilizes is listed on your ID card and in your benefit booklet. You may also call customer service.

Convenience

Not having enough time is one of the top reasons people forego dental care in the U.S. It may seem like a no-brainer, but finding a dentist whose location and hours fit into your everyday life will save you time and hassle in the long run. Keep in mind that “close to home” doesn’t necessarily mean more convenient! Think about your daily routine, like heading to work or taking the kids to school, to help identify the locations that will be easiest for you to get to.

Comfort Level

In the same way you wouldn’t walk into a car dealership and buy the first car you saw, doing some research before you make your first appointment with a new dentist will help you to be confident in your choice. Many clinics allow new patients to schedule a consultation before booking an official appointment so that you can see the office and meet your future dental team.

The ideal patient-dentist relationship is both positive and long-lasting. While heading in for dental work might not top your list of favorite pastimes, having a care team you like, trust and are able to see regularly makes it easier to keep your teeth healthy and clean for years to come.

For more useful information like this, check out the Delta Dental of Minnesota Blog.

Learn More

Find a Dentist

Our Find a Dentist tool makes it easy to find an in-network dentist near you. If you need some extra help navigating the tool, we have a tutorial.

Find a Dentist Tutorial

Using Your Benefits


You’ve enrolled in your dental plan. What now? Here are some suggestions on what to expect with your new plan and also how you can get the most out of it.

ID Cards

After you have completed your enrollment, your ID card will be mailed to you. Use this when you visit the dentist. ID cards include your unique member ID number. You will want to ensure your dentist has the most current version of your card to ensure your claims get paid quickly and accurately. On the back of the ID card you will find the phone number for customer service, feel free to give us a call if you have any questions.

How to Read a Benefit Summary or Booklet


Your benefit booklet is a review of the procedures and services that are covered under your plan, how often they are covered, and at what benefit level. You should receive this summary in the mail shortly after you sign up for your plan, and you should keep it for your reference.

You can also find a summary of your plan on our member portal.

Make sure you read our blog article What Dental Benefits Do – and Don’t Do to learn about how dental coverage can vary.

Manage Your Account


The secure member portal allows you to easily manage your account, view your benefits information, check your claims, order replacement ID cards and more! On the portal, you can:

  • Manage your account
  • View you benefits information
  • Check your claims
  • Order replacement ID cards
  • And more!

Manage you account here.

How to Read an EOB


After you see a dentist, you may receive an Explanation of Benefits (EOB) in the mail.

What is an EOB?

Glossary of Dental Insurance Terms


Insurance terms decoded! Terminology associated with dental insurance can be confusing. We created a glossary of common dental jargon to help you navigate terms you may encounter:

View Glossary

Recent Life Change


Pregnant? Recently retired? Here’s what you need to know about dental benefits and life changes.

Learn More