The Delta Dental Network
Delta Dental offers The Commonwealth of Virginia members its largest network, with 85% of all dentists in Virginia participating.* When you receive your dental care from a Delta Dental participating dentist, you will not be responsible for any charges that exceed Delta Dental’s allowance for covered services. This means your out-of-pocket expenses will be limited to the amount of your coinsurance, deductible and any amounts that exceed your annual or lifetime maximums.
Should you decide to receive dental care from a dentist who is not a member of the Delta Dental network, you will still receive benefits from your dental plan, but your share of the cost will likely be higher than if you received care from a participating dentist. In addition, you may have to file any claims yourself.
Below is more information on why it's important to make sure your dentist participates in the network covered by your plan.
In-network dentists
When you visit a dentist that participates in the Delta Dental network:
- The in-network dentist will file your claims to Delta Dental for you at no charge.
- Delta Dental will pay the dentist directly for covered benefits.
- The in-network dentist will accept Delta Dental's allowance for covered benefits. This means you pay only the applicable coinsurance and deductible for these covered services.
Out-of-network dentists
When you visit a dentist that does not participate with Delta Dental:
- You may be required to pay the non-participating dentist in advance for the entire bill and submit claim forms to Delta Dental yourself.
- Payment will be made directly to you unless your dentist agrees to accept payment from Delta Dental.
- Out-of-network dentists have not agreed to accept Delta Dental's allowance for their services. This means, in addition to what Delta Dental pays, you must pay the applicable coinsurance and deductible PLUS the difference between the out-of-network dentist's charges and Delta Dental's payment for covered benefits.
*Delta Dental Plans Association, December 2019