Compare Delta Dental Enrollment Channels and Rates

Delta Dental has three marketing channels for individuals and families to enroll in one of their dental PPO plans. Each of the channels has slightly different plans, coverage, and monthly rates. There are no enrollment periods with dental insurance. There are, however, waiting periods before the dental plan will share in the cost of certain dental services.

Delta Dental Enrollment Channels and Plans in California

In California, individuals and families can enroll a Delta Dental PPO plan

1. Direct with Delta Dental
2. Through Covered California IF they have health insurance through Covered California
3. Insurance for Everyone which is administered by the Morgan White Group

The dental plans summaries below are based on available information with an August 2024 enrollment.

Delta Dental offers two plans directly to consumers. The Basic plan, at $30.61 per month per adult, does not cover any major dental services and has a $1,000 maximum annual benefit. The Premium plan has a $2,000 annual maximum benefit and costs $68.33 per adult per month. If you are enrolled in a Covered California health plan, you can enroll in the Delta Dental PPO plan within 60 days of the initial enrollment of the health plan. The Covered California plan has a $1,500 maximum annual benefit and exceptional coverage for children.

The third marketing channel is Insurance for Everyone adminstered by the Morgan White Group. There are four different plans with higher deductibles than the Delta Dental direct plans. The maximum annual benefit ranges between $1,000 to $3,000. The rates are very competitive. The MWG plans offer family rates for households with a mix of adults and children.

Maximum Annual Benefit

The maximum annual benefit is the dollar amount the dental plan will pay for an enrolled member in a 12-month period. The maximum annual benefit is a big driver of the monthly dental rates. In this graph, the monthly adult rate for different dental plans is plotted against the maximum benefit associated with the plan. As the maximum benefit increases, so does the monthly rate.

Dental Waiting Periods

Another feature that affects rates is the waiting period. A waiting period is not a prohibition against having any dental services. The waiting period is the amount of time you must be enrolled in the dental plan before the plan will share in the cost of the dental service. For example, the dental plan you select has a six-month waiting period for minor restoration such as having a cavity filled. You have had the plan for three months and get a filling. You will pay the full contracted amount with the in-network dentist. After the six-month waiting period, the plan will pay a portion of the dental service subject to the waiting period.

For many plans, Delta Dental will waive the waiting periods if the enrolled member can prove they have had comparable PPO dental coverage with the last 60 days of their enrollment in the Delta Dental plan.

All of the offered dental plans have no waiting periods for diagnostic and preventive services such as cleanings, x-rays, and exams. It is typical for dental plans to have a six-month waiting period for minor restoration and twelve-month period for major restorative services. Just like some plans don’t include coverage for orthodontia, no matter how long you have the plan, some plans may not cover other services like dental implants. Even if there is no waiting period, Delta Dental may not fully cover the dental service 100 percent.

Member Cost-Sharing for Dental Services

The various dental plans have different cost-sharing percentages. While some plans, like the direct Basic and Premium plans, cover 100% of preventive and diagnostic services immediately (member pays $0 with in-network dentists), other plans offered through the Morgan White Group have progressive cost-sharing. After any waiting period is met for minor and major restorative dental services, the dental plan will begin to share in the cost of the dental service.

For example, after a six-month waiting period, the Delta Dental Basic plan will cover 50% of the minor or basic services, while the Premium plan covers 80%, member paying 20%. After 12 months, the Premium plan will cover 50% of major restorative services such as root canals, crowns, extractions, bridges, dentals implants.

Progressive Cost-Sharing

The Morgan White Group series of Delta Dental plans employ a three-year progressive cost-sharing structure for many minor and major dental services. For example, for diagnostic and preventive services under the Gold plan, the member pays 40% of the dental service the first year, 20% in the second, and in the third year of enrollment the plan covers services 100%, $0 to the plan member.

The progressive cost-sharing structure rewards the plan member for persistence. The plan member continues to stay enrolled in the dental plan and is rewarded with progressively lower dental costs. The trade-off of the higher cost-share in the first couple of years is a lower monthly rate for the dental plan.

If we return to the graph of rates versus maximum benefit, for the same maximum benefit, the Morgan White Gold plan is almost $20 less per month than the Delta Dental direct Premium Plan. The Premium plan does have a few services covered that are not included in the Gold plan, such as implants, teeth whitening, and orthodontia. Consequently, it is not an exact comparison between any of the plans.

This is where you need to review your past, current, and future dental services in selecting a dental plan. If you are certain that you will never use orthodontia, you may want to steer away from plans that include orthodontics because those plans will have higher monthly rates. If your dentist has told you that a dental implant may be in your future, you may want to lean toward a dental plan that will cover part of the cost of a dental implant.

Finally, if you know you will never have employer sponsored dental insurance – which are usually pretty good at a low monthly rate – you may want to seriously consider the Morgan White Group Delta Dental plans. Those plans have lower rates with the trade-off of higher member cost-sharing in the early years until year three when they mirror the cost-sharing structure of other individual and family dental plans.

Delta Dental Direct Plan Quotes

Morgan White Group Insurance For Everyone Delta Dental Plan Quotes

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