Your Delta Dental PPO coverage is administered by Delta Dental of Iowa. By encouraging preventive care, this dental program is designed to help contain dental costs. The key component of the Delta Dental PPO Program is our panel of Delta Dental PPO Dentists.
You may seek care from almost any dentist you wish. However, there are usually advantages when you receive services from PPO Dentists or Participating Delta Dental Dentists.
How much you pay for Covered Services depends on the benefit category of the service you receive and the dentist you receive services from. It is most often to your financial advantage to receive services from a PPO Panel Dentist or a Participating Delta Dental Dentist
Delta Dental of Iowa has contracts with PPO Dentists throughout the state of Iowa.
- PPO Dentists agree to accept their local Delta Dental Member Company's PPO Schedule, which may result in savings.
- Your deductible or coinsurance responsibility may be less for covered services your receive from a PPO versus a Participating Delta Dental Dentist or a nonparticipating dentist.
- PPO Dentists agree to file claims for you.
- Delta Dental of Iowa settles claims directly with PPO Dentists.
Participating Delta Dental Dentists:
Delta Dental of Iowa has contracting relationships with Participating Delta Dental Dentists throughout the state. The contracts with Participating Delta Dental Dentists include payment arrangements based on Delta Dental’s Maximum Plan Allowance.
- Participating Delta Dental Dentists agree to accept their local Delta Dental Member Company’s payment arrangement, which may result in savings.
- Your deductible or coinsurance responsibility may be more for Covered Services you receive from a Participating Delta Dental Dentist who is not a PPO Dentist.
- Participating Delta Dental Dentists agree to file claims for you.
- We settle claims directly with Participating Delta Dental Dentists.
When you receive services from nonparticipating (non-par) dentists, you will not receive any of the advantages that Delta Dental of Iowa's contracts with PPO Dentists or Participating Delta Dental Dentists offer. As a result, when you receive services from nonparticipating dentists, all of the following statements are true:
- Delta Dental of Iowa does not have contracting relationships with nonparticipating dentists and they do not agree to accept their local Delta Dental Member Company’s PPO 9 payment arrangement or any other payment arrangement. This means you are responsible for any difference between your nonparticipating dentist’s billed charge and the PPO Schedule or the Maximum Plan Allowance, as the case may be.
- Nonparticipating dentists are not responsible for filing your claims.
- We settle claims with you, not nonparticipating dentists. You are responsible for paying your dentist in full, including any deductible, coinsurance and non-approved charges you may owe.
- Nonparticipating dentists may charge for “infection control,” which includes the costs for services and supplies associated with sterilization procedures. You are responsible for any extra charges billed by a nonparticipating dentist for “infection control. Find more information in the Dental II coverage manual.
College of Dentistry
To increase educational opportunities for third and fourth year dental students, the College of Dentistry and University Benefits created the Student Dental Clinics Incentive (for Dental II and House Staff Dental participants).