Delta Dental PPO vs. Premier Network – What’s the Difference?
- PPO Network: 56% of dentist locations in California. PPO
Dentists are considered In-network for all PPO, PPO Plus Premier, and
Premier plans. - Premier Network: 90% of dentist locations in California. Delta
Premier dentists are considered Out-of-Network for all PPO and PPO plus Premier plans, and are considered In-Network for Premier plans.
Dentist Reimbursement by Plan
- PPO: Ina Classic or OPTIONS PPO plan, all dentists (PPO, Premier, and Non-contracted) are reimbursed at the lesser of the submitted charge or the PPO provider’s contracted fee.
- PPO Plus Premier: If a member visits a PPO dentist, charges are reimbursed at
the lesser of the submitted charge or PPO contracted fee. If visiting a Premier dentist, charges are reimbursed at the lesser of the submitted charge or the Premier provider’s contracted fee.
If a Delta Dental member goes to a Non-contracted dentist, charges are reimbursed at the lesser of the submitted charge OR the fee that satisfies a majority of dentists with the same training and geographical area. - Premier: If a member visits a PPO or Premier dentist, charges are reimbursed at the
lesser of the submitted charge or the Premier provider’s contracted fee. Non-contracted dentist charges are reimbursed at the lesser of the submitted charge OR the fee that satisfies a majority of dentists with the same training and geographical area.
For more information, view the following:
- Delta Dental PPO and PPO Plus Premier Network Information
- Delta Dental Online – About PPO and PPO Plus Premier
- Delta Dental Online – About Premier