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Products

Products We Offer

Delta Dental Premier - Delta Dental’s traditional fee for service dental program

Advantage Program - Delta Dental’s wide access PPO plan

Advantage Plus Program - Offers access to both Delta Dental Premier and Advantage Program dentists

Delta Dental PPO - Delta Dental’s PPO program designed for maximum cost savings

Delta Dental PPO Point of Service Program - Offers access to both Delta Dental PPO and Delta Dental Premier dentists

DeltaCare - A dental HMO program, administered by Flagship Dental Plans, a subsidiary of Delta Dental of New Jersey, Inc.

Delta Dental Patient Direct - A program for individuals, families, and group purchasers. Offers access to a network of dentists. This is not dental insurance.

Incentive Plans

Table of Allowances Programs

Visit ddpdelta.org, home of the new TRICARE/DeltaSelect USA Web site, containing information for uniformed services retirees and family members. It also contains the DeltaSelect USA dentist network. This program is administered by Delta Dental of California.

Delta Dental Premier (Coverage available in every state)

The affordable answer to indemnity plans, Delta Dental Premier applies the best in managed care and cost containment services with the traditional approved fee-for-service approach to dental care.

Delta Dental Premier Participating Dentists and Participating Specialists agree to pre-file their usual fee for each procedure commonly performed, and accept the least of their actual charge, their filed fee, or Delta Dental's established Premier Plan approved amount for the procedure as payment in full. This provides guaranteed copayment levels and a consistent level of charges to eligible patients. Claims for non-network providers’ services are generally paid based on the lesser of the dentist’s actual charge or the fee level as determined by Delta Dental for non-participating dentists (subject to group contract limitations).

Your benefit levels may vary based on the program in which your dentist participates.

You are responsible for payment of the difference between Delta Dental’s payment and the fee approved by Delta Dental.

This wording contains a general description of Delta Dental’s dental care programs for your convenient reference and there are additional product benefits you may wish to read about. All benefits are governed by the provisions of Delta Dental’s contracts.

Advantage Program (Coverage available only in New Jersey)

Advantage Program offers access to cost-efficient dental care provided by a large network of participating dentists on a fee-for-service basis, while allowing complete freedom of choice in dentist selection and lower dental plan costs.

Advantage Program dentists agree that their fee for covered service(s) will not exceed the Advantage Plan’s schedule of fees and agree not to balance bill you for the difference. You may also select a Delta Dental Premier dentist who is not in Advantage Program. Delta Dental Premier participating dentists agree to pre-file their usual fee for each procedure commonly performed, and accept the least of their actual charge, their filed fee, or Delta Dental’s Premier Plan approved charge as payment in full; however, Delta Dental’s payments will be based on the Advantage Program Table of Allowance. Claims for services provided by participating specialists are paid based on the least of their usual fee, their actual fees, or Delta Dental’s Premier Plan approved charge for the procedure. Claims for non-network providers’ services are generally paid based on the lesser of the dentist’s actual charge or the Advantage Plan's schedule of fees.

Your benefit levels may vary based on the program in which your dentist participates.

You are responsible for payment of the difference between Delta Dental’s payment and the fee approved by Delta Dental.

Advantage Plus Program (Coverage available only in New Jersey)

Where the eligible patient is treated by an Advantage Program dentist, the fee for the covered service(s) will not exceed the Advantage plan schedule of fees. Where the eligible patient is treated by a Delta Dental Premier dentist who does not participate in Advantage Program or by a participating specialist, you receive payment based on the Delta Dental Premier Plan approved charge and the dentist has agreed not to charge you more than the dentist's filed fee or Delta Dental's Premier Plan approved charge for the procedure(s). Claims for service(s) provided by dentists who are neither Delta Dental Premier, Advantage Program dentists, or participating specialists are generally paid based on the lesser of the dentist's actual charge or the fee level as determined by Delta Dental for non-participating dentists (subject to group contract limitations).

Your benefit levels may vary based on the program in which your dentist participates.

You are responsible for payment of the difference between Delta Dental’s payment and the fee approved by Delta Dental.

Delta Dental PPO (Coverage available in many states)

Delta Dental PPO allows employers to increase the value of dental benefits to employees, while actually decreasing their overall dental plan costs.

Delta Dental PPO participating dentists have agreed to accept the Delta Dental PPO schedule of fees as payment in full, offering guaranteed copayments to eligible patients using network dentists. These fees generally mean lower copayment costs to you. You may also select a Delta Dental Premier dentist who is not a Delta Dental PPO dentist. Delta Dental Premier participating dentists agree to pre-file their usual fee for each procedure commonly performed, and accept the least of their actual charge, their filed fee, or Delta Dental's Premier Plan approved amount as payment in full; however, Delta Dental’s payments will be based on the applicable Delta Dental PPO schedule. Claims for services provided by participating specialists are paid based on the lesser of their usual fee, their actual fees, or Delta Dental’s Premier Plan approved amount for the procedure. Claims for non-network providers’ services are generally paid based on the lesser of the dentist’s actual charge or the applicable Preferred schedule of fees.

Your benefit levels may vary based on the program in which your dentist participates.

You are responsible for payment of the difference between Delta Dental’s payment and the fee approved by Delta Dental.

Delta Dental PPO Point of Service Program (Coverage available in many states)

Where the eligible patient is treated by a Delta Dental Premier dentist who does not participate in the Delta Dental PPO Program or by a participating specialist, the dentist has agreed not to charge eligible patients more than the dentist's filed fee or Delta Dental's established Delta Dental Premier Plan approved charge, and Delta Dental will pay such dentists based on the least of the actual fee, the filed fee, or Delta Dental's established Premier Plan approved charge for the procedure(s). Claims for services provided by dentists who are neither Delta Dental Premier, Delta Dental PPO Program dentists, or participating specialists are generally paid based on the lesser of the dentist's actual charge or the fee level as determined by Delta Dental for non-participating dentists (subject to group contract limitations).

Your benefit levels may vary based on the program in which your dentist participates.

You are responsible for payment of the difference between Delta Dental’s payment and the fee approved by Delta Dental.

DeltaCare (Coverage available in many states)

Those who desire a managed care delivery system may consider DeltaCare, a capitated dental health maintenance organization (dental HMO-type program) administered by our subsidiary, Flagship Dental Plans.

Our gatekeeper approach ensures that employees receive the necessary and appropriate quality dental care at an affordable price.
Participating dentists meet rigid facility standards (established by Flagship Dental Plans).
Employees simply choose a primary care dentist convenient for their family who coordinates all necessary covered dental care and referrals to network specialists.
The primary care dentist receives a fixed monthly fee for treating members and their families, and specialists agree to discounted fees.
Patients have no claim forms to complete and no deductibles. There are copayments for some procedures, which are the obligation of the patient. Multiple program options are available.
DeltaCare offers the opportunity to reduce dental health costs while providing a comprehensive level of benefits.

In the age of rising health care costs, there is an alternative way to provide for you and your family's dental care needs - economically and conveniently through the DeltaCare program. DeltaCare is a dental HMO program, administered by Flagship Dental Plans, a subsidiary of Delta Dental of New Jersey, Inc.

You will enjoy the following advantages with the DeltaCare program:

No Claim Forms
The dental location you choose provides all primary dental services. There are no claim forms to complete.

No Deductibles
In the DeltaCare program there are no required deductibles to pay so your benefits begin immediately.

No Dollar Limit of Dental Benefits
No annual maximum.

No Pre-Existing Conditions Restricted
These conditions are not excluded in a DeltaCare program. Exception: work-in-progress.

Prepaid Plan Saves on Dental Costs
Your out-of-pocket savings are substantial. You know the exact cost prior to treatment; this aids in better fiscal planning for you and your family.

Specialty Services
The DeltaCare program offers services in dental specialty areas. These include periodontics (treatment of diseased gums and bone), endodontics (root canal therapy), and oral surgery procedures.

For a description of benefits and patient copayments, click here.

For information on limitations and exclusions, click here.

For a list of frequently asked questions, click here.

For rates and program details, please contact Diane Baquero at 973-285-4003 or e-mail Diane at dbaquero@deltadentalnj.com.

Delta Dental Patient Direct (A program for individuals, families, and group purchasers. Available only in New Jersey.)

Delta Dental Patient Direct is a dental membership program that offers access to a network of dentists who have agreed to provide dental care at fees no higher than the Delta Dental Patient Direct fee schedule. Delta Dental Patient Direct is not insurance. New Jersey residents who do not have dental insurance and are at least 18 years of age, and their dependents, are eligible to become members of Delta Dental Patient Direct. Members are responsible for paying 100% of the participating dentists fee up to the Delta Dental Patient Direct fee schedule for the dental procedure. Because Delta Dental Patient Direct is not insurance, there are no deductibles, no claims to file, no frequency limitations, and no waiting periods.

Incentive Plans

Delta Dental’s incentive program represents a variation of one of the program(s) we offer. With Delta Dental’s incentive plans, the percentage of coverage increases from the base benefit level by 10% annually (up to the stated maximum) so long as the eligible patient continues to utilize the program by being treated by a dentist on an annual basis. In the event that the eligible patient is not treated by a dentist during a particular annual period, the percentage of coverage will decrease in 10% increments each annual period in which treatment is not rendered, but never to less than the base benefit level.

Table of Allowances Program

With a Table of Allowances Program, Delta Dental will make payment based on the program description, but in no event will Delta Dental's payment be greater than the Table of Allowances.