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FAQs

Find answers to your questions below

What is so different about the dual choice plan?
What dental plans can employers choose from?
What dental plans can enrollees select?
How does the enrollee make a choice?
An enrollee asks, "My dentist is a Delta Dental dentist but is not on the list of DeltaCare USA dentists. C an I still receive treatment from this dentist?"
How can enrollees change dental plans?
Who should I contact with questions?

What is so different about the dual choice plan?

Enrollees have the option to change dental plans monthly, not just during the annual open enrollment period.

Changing is easy... enrollees simply call toll-free (866) 225-1112 by the 15th of the month, and we will make the change effective the first of the next month.

What dental plans can employers
choose from?

Employers choose a DeltaCare USA dental HMO plan in conjunction with one of our managed fee-for-service plans: either Delta Dental PPO, our preferred provider organization plan OR Delta Dental Premier, our traditional fee-for-service plan.

What dental plans can enrollees select?

At initial enrollment, enrollees who select:

DeltaCare USA, our dental HMO, also choose a primary care network dentist and indicate their choice on the enrollment form;
Delta Dental PPO or Delta Dental Premier simply complete and submit the enrollment form.

Enrollees can change their dental plan of choice by calling Customer Service by the 15th of the month (effective the first of the following month). The choice is theirs!

How does the enrollee make a choice?

Enrollment material is designed so that enrollees can compare the plans and choose the one that works best for their family. For example, here is a brief comparison of the types of dental options under Passport:

Program Type	Dental HMO	Managed fee-for-service
Product Name	DeltaCare USA	Delta Dental PPO	or DeltaPremier
Network type	Enrollees receive benefits only when they visit a DeltaCare USA dentist.	Enrollees receive optimum benefits and lower out-of-pocket costs when they visit a PPO network dentist. However, services are available from any licensed dentist.	Enrollees may visit any licensed dentist. Visiting a Delta Dental Premier dentist provides added protection from overbilling and unbundling of services.
Network size	There are nearly 2,500 general dentists, 800 specialists and 300 orthodontists in our network. Many of these dentists are in group practices with expanded hours and accessibility.	There are more than 11,000 PPO dentist locations in California. The network includes all specialties.	Delta contracts with more than 23,000 dentist locations in California — 92% of California dentists.
Benefits	Benefits are listed by procedure along with specific dollar copayments. Enrollees can clearly identify the "patient pays" portion of the benefits. There are more than 250 covered procedures.	Enrollees are responsible for a percentage of the benefit depending on the category of coverage. Most plans cover preventive services at 100%. Often, PPO programs are structured to pay higher benefits in-network. PPO dentists agree to all of the patient guarantees that Delta Dental Premier dentists agree to.	Enrollees are responsible for a percentage of the benefit depending on the category of coverage. Delta dentists are prevented from balance-billing the patient for covered services prenegotiated with Delta, and cannot unbundle services for the insurance part of the payment.
Deductibles and maximums	There are no annual maximums or deductibles on general services.	Annual maximums and deductibles usually apply.	Annual maximums and deductibles usually apply.
Claims and paperwork	There are no claim forms or paperwork associated with DeltaCare.	PPO dentists handle claims and paperwork free of charge.	Delta Dental Premier dentists handle claims and paperwork free of charge.
Plan description	DeltaCare	PPO	Delta Dental Premier

DeltaCare Plan Benefits

DeltaCare USA is our dental HMO. DeltaCare USA plans provide:

Optimal coverage. DeltaCare USA offers comprehensive benefits at predictable, affordable prices. There are no annual maximums or deductible on general services. The plan also includes orthodontic coverage.
Access. DeltaCare is California's largest dental HMO network with nearly 3,700 general dentist locations throughout the state.
Quality assurance. Our DeltaCare dentists pass stringent reviews for quality, access, safety and experience before they are selected for the network.
User-friendly administration. No claim forms are required for general services.
Cost effectiveness. DeltaCare offers excellent value, predictable costs and economical prices, saving money for both enrollees and group purchasers.

PPO Plan Benefits

Our PPO product offers affordable freedom of choice. Its unique advantages include:

Cost savings. Group purchasers and enrollees save money due to Delta Dental's special fee agreements with PPO dentists.
Access. More than 11,000 California dentist locations participate in the PPO network.
No forms to complete. PPO dentists handle claims and paperwork at no charge.
Guaranteed copayments. The enrollee pays only the benefit copayment for covered services. Delta dentists do not balance bill for covered services; they charge only their accepted fees.
Out-of-network safety net. If enrollees elect to go out of the PPO network but choose a Delta dentist, they still receive all of the protection of The Delta Difference^® (claims convenience, guaranteed copayments and more).

DeltaPremier Plan Benefits

Our traditional fee-for-service product provides the following advantages:

Access. Services are available from any licensed dentist worldwide, including more than 22,000 California dentist locations.
Cost management. Delta dentists fees are prenegotiated and measured by strict criteria. Our participating dentist contracts provide enrollees and group purchasers predictable savings and manageable costs.
Delta dentists handle claims and paperwork free of charge.
No balance-billing. Delta dentists agree to charge the patient only the copayment portion of the benefit.

An enrollee asks, "My dentist is a Delta dentist but is not on the list of DeltaCare dentists. Can I still receive treatment from this dentist?"

Delta Dental's Passport product allows you to enroll with either a DeltaCare dentist or a Delta (Premier or PPO) dentist. The services that are covered and the copayments you are responsible for depend on which dental plan you've enrolled in. If you are not sure, be sure to confirm which dental plan you selected at enrollment to determine which network applies. If you wish to change plans, you can call the toll-free Customer Service number to do so.

It is important to know that if you are enrolled in DeltaCare, and receive treatment from a dentist who is not a DeltaCare dentist, the cost for those services will not be covered. The DeltaCare plan is only available when using the DeltaCare network. It's easy to contact Passport's toll-free Customer Service number to change dental plans (see question below) if you decide to see a non-DeltaCare dentist.

How can enrollees change dental plans?

Enrollees simply call Passport's Customer Service department toll-free at (866) 225-1112 by the 15th of the month to change dental plans to take effect the first of the next month.

Whom should I contact with questions?

You may contact your Delta sales executive or account manager, or you may call (866) 225-1112, and listen to the options that will direct your call to the person who can best assist you.