Delta Dental of Massachusetts Delta Dental PPO Plus Premier – (Formally Blue Cross and Blue Shield Dental Blue) Download Benefit Summary for Delta Dental PPO Plus Premier – (Formally Dental Blue) Delta Dental PPO – (Formerly Blue Cross and Blue Shield Dental Blue PPO) Download Benefit Summary Delta Dental PPO – (Formerly Dental Blue PPO) How the Delta Dental PPO Plus Premier Works The Delta Dental PPO Plus Premier program combines two of Delta’s dental networks – Delta PPO and Delta Premier network– giving you access to dentist that participate in both. When you need dental services, you will be able to select a dentist from either the Delta Premier or the Delta PPO network of dentists. However, your out-of-pocket expenses will be different, depending on which network you select.
To verify if your dentist is part of the Delta Dental PPO Plus Premier, refer to the Directory of Participating Providers available thorough Delta Dental or Delta Dental’s website www.deltadentalma.com. You can also call Delta Dental Customer Service department at (800) 872-0500. When choosing a participating provider, keep in mind that the deepest discounts will be received with a Delta PPO provider.
How the Delta Dental PPO Works
MAXIMUM PAYMENT The maximum payment each calendar year is $1,500 for each insured person, excluding orthodontia. Reimbursement for orthodontia procedures is up to 50% of the orthodontist’s charges to a lifetime maximum of $2,00 for each insured person. PRE-TREATMENT ESTIMATES If your dentist expect that dental treatment will involve a series of covered services, he or she should file a copy of the treatment plan with Delta Dental BEFORE these services are rendered to you or your dependent. A treatment plan is a detailed description of the procedures that the dentist plans to perform and includes an estimate of the charges for each service. Pre-treatment estimates are recommended for any services that are $300 or more, but are not mandatory. Upon receipt of the treatment plan Delta Dental will notify you and your dentist about the maximum extent of your benefits for the services reported. If your dentist does not file a treatment plan for a pre-treatment estimate, Delta Dental will decide the extent of your benefit based on a review of those services using standards that are generally considered as accepted dental practices. |