Question: I currently do not have dental insurance. I used to have it through my prior job. I want to keep my same dentist, so I am seeking a Delta Dental PPO plan for individuals. I never bought a dental insurance plan myself. I just got what a job offered. What should I look for? I see many different Delta Dental plans. 

Answer: In most states, we offer a Delta Dental PPO plan and or plans. First, decide what *maximum limation will work best for you. We have Delta Dental PPO’s plans with maximum limitations ranging from $ 1,000 per person to $ 5,000 per year. You will want to know the plan *waiting periods and if they have a yearly *deductible. Then, review the plan’s benefits and how they cover you. All our Delta dental plans have a first-year, second-year, and third-year benefit chart showing what they cover for each type of dental service per year until the third year when benefits will stay the same. Lastly, read each plan’s limitations and exclusions to know what the plan limits or excuses benefit from. 

• Maximum Limitation: A maximum limitation is the maximum amount a dental plan will pay for covered dental services within a specific period, usually one year. For instance, if a dental plan has a $1,000 maximum limitation per year, once you have received $1,000 worth of covered dental services within that year, you will be responsible for paying for any additional services out of pocket. The maximum limitation is typically per person per year. It’s essential to consider the maximum limitation when choosing a dental plan, as it can affect the cost of care you receive.
• Waiting Periods: A waiting period is a specified amount of time that must pass before certain dental insurance plan benefits become available to the policyholder. For instance, a dental plan may have a twelve-month waiting period for major procedures, such as crowns or root canals. This means that the policyholder must wait twelve months from the date of enrollment before being able to receive coverage for these procedures. Waiting periods are designed to prevent people from enrolling in a plan only when they need expensive procedures and then canceling their coverage once the procedures are complete. It’s vital to consider waiting periods when choosing a dental plan, as they can affect when you receive certain benefits.
• Deductibles: A deductible is a specified amount of money that a policyholder must pay out of pocket before their insurance coverage begins to pay for covered services. For instance, if a dental plan has a $50 deductible and a policyholder receives a covered service that costs $300, they will be responsible for paying the first $50. The insurance plan will cover the remaining $250, per the policy terms. Deductibles are typically annual, meaning that they must be met once per year. It’s important to consider deductibles when choosing a dental plan, as they can affect the out-of-pocket costs you will be responsible for.

If you have any questions about our individual/family dental insurance plans, call our member service line at 310-534-3444, as we are happy to help you find the right plan for your dental needs.