Delta Dental is one of the largest and most well-known dental insurance providers in the United States, offering a variety of plans designed to meet the needs of different individuals and families. Two of its most commonly offered plans are Delta Dental Premier and Delta Dental PPO. While both plans are designed to provide dental coverage, they differ in terms of provider networks, flexibility, cost, and benefits. This article will explore whether Delta Dental Premier is the same as Delta Dental PPO and help you understand the key differences between these two plans.
What Is Delta Dental Premier?
Overview of Delta Dental Premier
Delta Dental Premier is a traditional dental insurance plan offered by Delta Dental. This plan is designed to provide comprehensive dental coverage through an extensive network of participating dentists, known as the Premier network. It is one of the most common plans that Delta Dental offers and is popular among individuals who prefer seeing a wide range of dentists.
Under the Premier plan, insured individuals can visit any dentist, but they will save more if they visit a Delta Dental Premier network dentist.
This plan allows for more flexibility in terms of choosing providers, but the savings may not be as significant as with a PPO plan.
Key Features of Delta Dental Premier
Wide Network of Dentists: Delta Dental Premier has a large network of participating dentists, ensuring that you have access to a variety of dental professionals.
Cost Structure: You will typically pay less out-of-pocket when visiting a Delta Dental Premier dentist. However, if you choose a non-network dentist, your costs may be higher.
No Referral Requirement: There are no referrals needed to see a specialist, making it easier to access specialized dental care.
Lower Deductibles: Delta Dental Premier often has lower deductibles compared to PPO plans, which may make it a more affordable option for some individuals.
What Is Delta Dental PPO?
Overview of Delta Dental PPO
Delta Dental PPO is another dental insurance plan option provided by Delta Dental. Unlike Delta Dental Premier, the PPO (Preferred Provider Organization) plan has a more restricted network of dentists, known as the PPO network. The PPO plan offers a higher level of coverage when you visit a PPO dentist but still provides some level of coverage for non-network providers.
With a Delta Dental PPO plan, you will have a lower out-of-pocket cost if you see a dentist in the PPO network. However, you are allowed to visit any dentist of your choice, but if the dentist is outside the PPO network, you may face higher costs and fewer benefits.
Key Features of Delta Dental PPO
Lower Costs with PPO Dentists: Like the Premier plan, PPO plans offer lower costs when you visit an in-network provider.
However, the PPO network typically offers greater discounts than the Premier network.
Flexibility in Provider Choice: You can visit any dentist, but your costs will be higher if you choose to go outside the PPO network.
Referral Requirements: PPO plans may require you to get a referral to see a specialist in some cases.
Higher Deductibles: Delta Dental PPO plans tend to have higher deductibles than Premier plans, which may affect the overall cost for policyholders.
Key Differences Between Delta Dental Premier And Delta Dental PPO
While both Delta Dental Premier and Delta Dental PPO provide dental coverage, there are several important differences that may influence your choice of plan. Below are the main distinctions:
1. Network Size and Flexibility
Delta Dental Premier: The Premier plan offers access to a large network of dentists, which may include some who are not part of the PPO network. However, you will save more money by choosing a Premier network dentist.
Delta Dental PPO: The PPO plan offers a more limited, but typically more cost-effective network. You can still visit non-network providers, but it will cost you more. The PPO plan is ideal for individuals who want a greater degree of savings when visiting network dentists.
2. Out-of-Pocket Costs
Delta Dental Premier: The out-of-pocket expenses with the Premier plan tend to be lower when you see a network dentist, but not as low as with the PPO plan.
Delta Dental PPO: If you see an in-network PPO dentist, your out-of-pocket costs will be lower than with the Premier plan.
However, if you go out-of-network, your costs can be higher than with the Premier plan.
3. Referral and Specialist Access
Delta Dental Premier: There are typically no referral requirements for seeing a specialist under the Premier plan, giving you more freedom when seeking specialized care.
Delta Dental PPO: Similar to Premier, the PPO plan may or may not require a referral to see a specialist, depending on the specifics of the plan and your location.
4. Coverage for Non-Network Dentists
Delta Dental Premier: Premier plans generally offer better coverage for out-of-network providers compared to PPO plans.
However, it may not cover as much as seeing an in-network provider.
Delta Dental PPO: While the PPO plan will still cover some out-of-network services, the coverage is typically less than the Premier plan, and you will be required to pay higher out-of-pocket costs.
5. Premiums
Delta Dental Premier: The premiums for a Premier plan are usually lower than for a PPO plan, making it a good option for those who want a more affordable insurance option while maintaining access to a wide range of dentists.
Delta Dental PPO: PPO plans generally have higher premiums but offer greater savings if you use in-network providers. The higher premiums are often balanced out by the lower cost-sharing when using PPO network dentists.
Which Plan is Better for You?
Factors to Consider
Choosing between Delta Dental Premier and Delta Dental PPO depends on your personal needs and preferences. Here are some factors to consider when deciding which plan is better for you:
1. Provider Flexibility
If you want the freedom to see a wider range of dentists and are okay with paying a bit more, then the Delta Dental Premier plan might be a better choice.
If you are looking for a plan with a more cost-effective network and are willing to use a more restricted list of dentists, then the Delta Dental PPO plan could be the right fit.
2. Out-of-Pocket Costs
If you are looking to keep your costs low, you may find that the Delta Dental PPO plan offers more savings when using network providers.
On the other hand, if you need the flexibility to see any dentist without worrying about out-of-pocket expenses, the Delta Dental Premier plan may be more appropriate.
3. Premiums and Coverage
Consider whether the lower premiums of Delta Dental Premier will meet your needs for dental care, or if you are willing to pay a slightly higher premium for the additional coverage offered by Delta Dental PPO.
4. Specialist Access
If you expect to need specialized dental care and don’t want to deal with referrals or network restrictions, Delta Dental Premier may be the better option.
Conclusion
In summary, Delta Dental Premier and Delta Dental PPO are not the same, though they both offer valuable dental coverage.
The Premier plan provides access to a wider network of dentists and offers lower out-of-pocket costs when you see a network provider. However, if you want to save more on premiums and out-of-pocket costs for in-network care, the PPO plan may be the better choice for you.
