Delta Dental High Plan vs Low Plan: Which Is Best?
Choosing the right dental insurance can feel overwhelming. With so many options, understanding the differences between plans is crucial for your oral health and your wallet. This comparison dives deep into the details of Delta Dental’s offerings, helping you make an informed decision.
We’ll be taking a close look at the Delta Dental High Plan versus the Low Plan. Both plans from Delta Dental offer a range of benefits, but the specifics can vary significantly. Understanding these variations is key to selecting the plan that perfectly aligns with your dental needs and budget.
Whether you’re prioritizing comprehensive coverage or seeking a more affordable option, this comparison of the Delta Dental High Plan and Low Plan will provide valuable insights. We’ll explore everything from premiums and deductibles to covered services and out-of-pocket costs, so you can confidently choose the best plan for you.
Specs at a Glance
| Feature | High Plan | Low Plan |
|---|---|---|
| Annual Maximum Benefit | Higher | Lower |
| Preventive Services Coverage | 100% | 100% |
| Basic Services Coverage | Higher | Lower |
| Major Services Coverage | Higher | Lower |
| Deductible (per person) | Lower | Higher |
| Orthodontia Coverage (Adult & Child) | Yes | Sometimes |
| Implant Coverage | Yes | Sometimes |
| Waiting Periods | Shorter | Longer |
| Network Access | Larger | Smaller |
| Out-of-Network Coverage | Yes | Yes |
| Teeth Whitening | Sometimes | No |
| Vision Benefit | No | No |
Feature-by-Feature Breakdown
Annual Maximum Benefit
- Delta Dental High Plan: Offers a significantly higher annual maximum benefit, allowing for more extensive and costly dental procedures to be covered. This is beneficial for individuals needing major dental work. However, premiums are higher.
- Low Plan: Provides a lower annual maximum benefit. This plan is more suitable for those who anticipate only basic dental care needs. It offers lower premiums but may leave you with out-of-pocket expenses for extensive treatments.
- Winner: High
Deductible
- Delta Dental High Plan: Typically has a lower deductible, meaning you pay less out-of-pocket before insurance coverage begins. This is an advantage for those who anticipate needing dental care regularly. However, you pay higher premiums.
- Low Plan: Usually features a higher deductible. This results in lower monthly premiums, but you’ll pay more upfront when needing dental services.
- Winner: High
Preventive Care Coverage
- Delta Dental High Plan: Often covers preventive care (cleanings, exams, X-rays) at 100% with no deductible. This encourages regular checkups and can help prevent more serious dental problems.
- Low Plan: May cover preventive care at 100% as well, but sometimes there might be a deductible or lower coverage percentage.
- Winner: Tie
Basic Services Coverage (Fillings, etc.)
- Delta Dental High Plan: Provides a higher percentage of coverage for basic services, like fillings, typically around 80% or higher. This reduces your out-of-pocket costs for common procedures.
- Low Plan: Often covers basic services at a lower percentage, such as 50% or 60%. This means you’ll pay a larger portion of the cost for these services.
- Winner: High
Major Services Coverage (Crowns, Bridges, etc.)
- Delta Dental High Plan: Offers the best coverage for major services, often covering 50% or more. This is crucial if you need expensive treatments like crowns or bridges.
- Low Plan: Provides a significantly lower coverage percentage for major services, sometimes as low as 0% or 20%. This leaves you with substantial out-of-pocket costs for major dental work.
- Winner: High
Orthodontia Coverage
- Delta Dental High Plan: May include orthodontia coverage for both adults and children, often with a lifetime maximum benefit. This is a considerable benefit for those seeking braces or Invisalign.
- Low Plan: Often lacks or provides very limited orthodontia coverage. This means you will likely pay the full cost of orthodontic treatment.
- Winner: High
Premium Cost
- Delta Dental High Plan: Comes with higher monthly premiums due to its comprehensive coverage. This is a trade-off for the increased benefits and lower out-of-pocket costs when you need dental care.
- Low Plan: Has lower monthly premiums, making it more affordable on a monthly basis. However, you’ll likely pay more out-of-pocket when needing dental services.
- Winner: Low
Waiting Periods
- Delta Dental High Plan: May have shorter or no waiting periods for certain services (e.g., preventive care, fillings). This allows you to access benefits sooner after enrolling.
- Low Plan: Often has waiting periods, particularly for major services. This means you may have to wait several months before coverage kicks in for procedures like crowns or bridges.
- Winner: High
Winner by Category
| Category | Winner |
|---|---|
| Annual Maximum Benefit | High Plan |
| Preventive Care Coverage | Tie |
| Basic Services Coverage | High Plan |
| Major Services Coverage | High Plan |
| Deductibles | High Plan |
| Orthodontia Coverage | High Plan |
| Overall Value (for comprehensive care) | High Plan |
| Cost-Effectiveness (for basic care) | Low Plan |
What They Have in Common
- Preventive Care: Both plans cover 100% of preventive services, such as cleanings and checkups, emphasizing the importance of routine dental care for overall oral health. This shared benefit encourages members to prioritize regular visits to maintain healthy teeth and gums.
- Network Access: Both plans offer access to Delta Dental’s extensive network of dentists, ensuring members can find a provider. This allows members to choose from a wide range of dentists.
- Out-of-Network Coverage: Both plans offer some coverage for out-of-network dental care, providing flexibility for members who may need to see a dentist outside the Delta Dental network. However, the cost may be higher.
- Coverage for Diagnostic Services: Both plans cover diagnostic services, such as X-rays and exams, which are essential for early detection of dental problems. This promotes proactive dental care.
- Focus on Oral Health: Both plans are designed to help members maintain good oral health, with a focus on preventive care and coverage for essential dental services. This shared goal underscores the importance of dental care.
Delta Dental High Plan Vs Low Plan Buying Guide
Understanding Your Dental Needs
Before choosing between Delta Dental’s high and low plans, assess your dental health needs. Consider factors like your current oral health, any history of dental issues, and anticipated future needs. High plans are designed for individuals requiring extensive dental work. Low plans are better suited for those who prioritize preventative care and have minimal dental concerns. A thorough evaluation will help you determine the plan that best aligns with your situation. Consider how often you visit the dentist and the type of treatments you require.
Coverage Differences: High Plan
Delta Dental’s high plan typically offers comprehensive coverage, including preventative, basic, and major services. Expect higher reimbursement rates for procedures like fillings, crowns, root canals, and even orthodontics. The high plan often features a higher annual maximum benefit, providing greater financial protection against unexpected dental expenses. This plan is ideal for individuals anticipating significant dental treatments in the near future. Review the plan’s specific details on waiting periods and pre-authorization requirements.
Coverage Differences: Low Plan
Delta Dental’s low plan emphasizes preventative care, covering checkups, cleanings, and X-rays at a higher percentage. Basic services, such as fillings, may be covered at a lower percentage. Major services, like crowns or root canals, might have limited coverage or higher out-of-pocket costs. The low plan is cost-effective for those with generally healthy teeth. This plan is a good option if you have a low risk of needing extensive dental work. Check the plan’s limitations on specific procedures.
Cost Considerations: Premium and Deductible
Premiums for the high plan are significantly higher than the low plan, reflecting the broader coverage. The high plan typically has a lower deductible or no deductible at all, making it easier to access benefits immediately. The low plan usually has lower monthly premiums but a higher deductible. Evaluate your budget and how much you’re comfortable spending on premiums versus out-of-pocket expenses. Consider how frequently you need dental care to make the best decision.
Network of Dentists and Access to Care
Both plans offer access to Delta Dental’s extensive network of dentists. However, some plans may have more restrictions regarding out-of-network providers. Check the plan’s provider directory to ensure your preferred dentist is in-network. In-network providers usually offer discounted rates, minimizing your out-of-pocket expenses. Confirm the plan’s rules about referrals and specialist access. Consider the geographic availability of dentists.
Making the Right Choice for You
The best plan depends on your individual circumstances. If you anticipate needing significant dental work, the high plan offers better financial protection. If you prioritize preventative care and have minimal dental needs, the low plan might be a more affordable option. Compare the coverage details, premiums, deductibles, and network of dentists before making a decision. Carefully read the plan documents to understand all the terms and conditions. Choose the plan that best aligns with your oral health needs and financial situation.
Who Should Buy What?
Buy delta dental high plan If…
- You anticipate needing significant dental work, such as crowns, bridges, or implants.
- You want lower deductibles and higher annual maximum benefits.
- You have a family and anticipate needing orthodontia for children.
- You prioritize having the broadest coverage and the least out-of-pocket expenses.
Buy low plan If…
- You are generally in good dental health and only need basic preventive care.
- You are looking for a more affordable plan.
- You are comfortable with higher deductibles and lower annual maximum benefits.
- You do not anticipate needing major dental work in the near future.
Frequently Asked Questions
What’s the difference between a high plan and a low plan?
High plans offer more comprehensive coverage, including major services like crowns and root canals, with higher reimbursement rates and a larger annual maximum. Low plans prioritize preventative care with lower monthly premiums but may have limited coverage for major services and higher out-of-pocket costs. They are designed for individuals with fewer anticipated dental needs.
Does the high plan cover orthodontics?
Many high plans include some level of orthodontic coverage, such as braces for children and adults. The specific coverage details, including the lifetime maximum benefit, will vary depending on the plan. Be sure to review the plan’s details, including any waiting periods, and limitations on age or treatment type.
Are preventative services covered under both plans?
Yes, both high and low plans cover preventative services like routine checkups, cleanings, and X-rays. The high plan typically covers these services at a higher percentage, potentially with no out-of-pocket cost. The low plan usually covers these services at a slightly lower percentage, but they remain a key component of the plan.
How do I find a dentist in the Delta Dental network?
You can use Delta Dental’s online provider directory or call their customer service to find a dentist within your plan’s network. The directory allows you to search by location, specialty, and other criteria. Verify the dentist’s participation in your specific plan to ensure in-network benefits.
What is a deductible?
A deductible is the amount you must pay out-of-pocket for covered dental services before your insurance starts to pay its share. The high plan might have a lower deductible or none at all, while the low plan usually has a higher deductible. The deductible resets annually.
What is an annual maximum?
An annual maximum is the total amount your dental plan will pay towards covered services in a year. High plans typically have a higher annual maximum benefit than low plans, providing more financial protection for extensive dental work. Once the annual maximum is reached, you are responsible for the full cost of any additional services.
How do I choose the right plan for me?
Consider your current and anticipated dental needs, your budget, and your risk tolerance. If you anticipate needing extensive dental work, the high plan is likely the better choice. If you have minimal dental needs and are looking for affordability, the low plan may be more suitable. Compare the coverage details, premiums, and deductibles.
Final Verdict
The ideal Delta Dental plan hinges on individual dental needs and financial considerations. The high plan offers superior coverage for a wider range of services, including major procedures, but comes with higher premiums. The low plan prioritizes affordability with a focus on preventative care. For those anticipating significant dental work or seeking comprehensive coverage, the high plan is the winner.
Winner: Delta Dental High Plan