You probably know that a root canal and crown can save a tooth, but it can get pricey fast. If your plan includes delta dental covered root canal and crown services, you could pay half or less after meeting your deductible. In this guide, you’ll learn how your Delta Dental plan works, easy steps to take before treatment, and tips to keep more money in your pocket.
You’ll walk away understanding benefit levels, out-of-pocket estimates, and where to find an in-network specialist. Let’s dive in.
Understanding your Delta Dental plan
Before you schedule anything, get familiar with key plan terms that affect your coverage and costs.
Benefit levels
- Preventive care (cleanings, X-rays) usually at 100%
- Basic procedures (fillings, extractions) at 80%
- Major work (crowns, bridges, root canals) at 50%
Deductibles and maximums
Most Delta Dental plans have an annual deductible—often $50 per person—before major coverage kicks in. You’ll also see an annual maximum (commonly $1,500–$2,000), which is the total Delta Dental will pay in a year.
Waiting periods
Some major services require waiting periods. For example, crowns or root canals may be excluded for the first six months. Check your summary of benefits to avoid surprises.
In-network vs out-of-network
Delta Dental negotiates fees with in-network dentists. That means lower costs for you. Out-of-network providers may charge their full fee, and you’ll pay any amount over the plan allowance.
Root canal and crown coverage details
Your delta dental covered root canal and crown benefits vary by plan type. Here’s how the two common PPO options stack up.
PPO Basic
- Root canals: generally excluded
- Crowns: not covered
PPO Premium
- Root canals: 50% after deductible
- Crowns: 50% after deductible
If you have a different Delta Dental plan, coverage levels may shift. Always consult your benefit booklet or member portal for exact details.
Steps to take before treatment
Getting your ducks in a row before that first appointment saves time and money.
- Review your benefits
Look for coverage percentages, waiting periods, and annual limits. - Get a pre-treatment estimate
Ask your dentist to submit a predetermination to Delta Dental. It breaks down insurer payments and your share. - Confirm in-network status
Verify your dentist or endodontist is in Delta Dental’s network to tap fee discounts. - Schedule strategically
If you’re near your annual maximum, consider timing treatment early in the benefit year. - Ask about alternative options
In some cases, less invasive treatments may meet both your dental and budget needs.
What is a pre-treatment estimate?
A predetermination—sometimes called a pre-treatment estimate—is a request you or your dentist sends to Delta Dental. It spells out what the plan will pay and what you owe. Processing takes about 10–14 business days, but online submissions can be quicker.
Finding an in-network provider
Why stick with an in-network dentist? Simple: negotiated fees mean you pay less.
How to search the network
- Use Delta Dental’s online provider search tool
- Filter by specialty (endodontist for root canals)
- Check patient reviews and office location
Questions to ask the office
- Do you accept my specific Delta Dental plan?
- Will you file claims electronically?
- Can you provide a cost estimate before treatment?
If you’re curious about how other insurers handle major dental work, see aetna root canal and crown coverage for a quick comparison.
Estimating your out of pocket costs
Having ballpark figures helps you budget and avoid sticker shock. Below is a typical range based on 2024 national averages and 50% coverage after deductible.
Procedure | Average fee | Plan pays 50% | Your share 50% |
---|---|---|---|
Front tooth root canal | $800–$1,000 | $400–$500 | $400–$500 |
Molar root canal | $1,200–$1,500 | $600–$750 | $600–$750 |
Porcelain-fused crown | $1,000–$1,500 | $500–$750 | $500–$750 |
Your actual out-of-pocket will depend on:
- Whether you’ve met your deductible
- Your plan’s exact coverage percentage
- Any remaining annual maximum balance
For details on crown recementation coverage, check out delta dental coverage for crown recementation.
Tips to maximize your benefits
A few simple moves can stretch your dental dollars further.
- Schedule preventive visits early
Preventive services don’t count toward your maximum and keep major issues at bay. - Coordinate with your spouse or partner
If you each have coverage, plan work across two benefit years. - Use a health savings account (HSA)
Pay your share with pre-tax funds to save more. - Bundle treatments
If you need multiple crowns, grouping them in one year can make the most of your maximum. - Double-check claim submissions
Ensure your dentist includes all necessary member information to avoid denials or delays.
Other Delta restorative services
Delta Dental covers more than just root canals and crowns. Here’s a quick look at common services for retirees.
- Dental implants
See delta dental dental implant coverage for seniors - Full dentures and partials
Learn more at dentures covered by delta dental for seniors - Bridges
Compare with bcbs covered dental crown and bridge - Full mouth reconstruction
Details at full mouth reconstruction delta dental coverage
Knowing your options helps you plan long-term care, whether it’s a two-appointment crown or a full arch restoration.
Frequently asked questions
Will Delta Dental cover a crown after root canal?
Yes, under PPO Premium plans crowns are covered at 50% after your deductible.
What’s the waiting period for major services?
Most plans have a six- to twelve-month waiting period. Review your benefit booklet.
Can I go out-of-network if needed?
You can, but you’ll pay the difference between the provider’s fee and Delta Dental’s allowance.
How many appointments for a crown?
Typically two. Some offices offer same-day crowns with in-office milling machines.
Does preventive care count toward my maximum?
No, preventive services like cleanings and exams are covered at 100% and don’t reduce your annual maximum.
Key takeaways
- Delta Dental plans often cover 50% of major work, after a deductible
- Always confirm in-network status for lower fees
- Use a pre-treatment estimate to avoid surprises
- Leverage preventive care and HSAs to save more
- Explore related services like implants and dentures for long-term dental health
Ready to move forward? Contact your dentist for a predetermination, book that cleaning, and keep smiling with confidence. If you have tips or questions, drop a comment below so others can benefit too.