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Guide to Delta Dental programs
Delta Dental Premier * In Texas, Delta Dental offers dental provider organization (DPO) plans. Delta Dental Premier®Delta Dental Premier is Dental Dental's original fee-for-service program. Payment is based on accepted fees and is sent directly to the dentist. Under the Delta Dental Premier table of allowances program, Delta Dental pays a percentage of a table allowance, and the patient is responsible for the balance, up to the dentist's accepted fee. The Delta Dental PPO program provides enrollees with enhanced benefits when visiting a network general dentist, pediatric dentist, prosthodontist or orthodontist. Delta Dental oral surgeons, periodontists and endodontists are not under a Delta Dental PPO contract, but treatment provided by these Delta Dental specialists is payable at the program's full in-network level. Most Delta Dental PPO dentists receive payment based on the Delta Dental PPO schedule of allowances. Non-network dentists usually receive a percentage of their accepted fees. *In Texas, Delta Dental offers dental provider organization (DPO) plans. DeltaCare USA is a prepaid plan that features set copayments, no annual deductibles and no maximums for covered benefits. In most states, enrollees must select a primary care dentist in the DeltaCare USA network from whom they receive treatment as in a traditional DHMO. *In some states, DeltaCare USA is offered as an open access plan where enrollees can obtain treatment from any licensed dentist; however, deductibles and maximums may be applied to out-of-network treatment. TRICARE Retiree Dental Program (TRDP)
TRDP is Delta Dental's national PPO program for retirees of the Uniformed Services and their families. Enrollees may receive treatment from any dentist. Network dentists agree to honor the program's PPO fees for their region. Direct payment is made only to Delta Dental dentists.
Denti-Cal is the state's Medicaid dental program that Delta Dental administers in partnership with the California Department of Health Services, allowing Medicaid beneficiaries (adults and children) to receive comprehensive dental services. Beneficiaries must visit a Denti-Cal network dentist who is paid according to a fee schedule.
Healthy Families is a state program administered by Delta Dental and three other dental plans to provide dental coverage to children of working families with incomes one to two times the federal poverty level. Dental services covered under Healthy Families include most preventive, basic and major restorative services. Beneficiaries who select Delta Dental's Healthy Families program choose from a network of dentists who are paid on a fee-for-service basis. | ||||||||||||||||