Delta Dental full upper and lower dentures coverage can feel like navigating a maze, right?
If you’re over 60, retired or caring for someone who is, you want clarity on what your plan will actually pay.
In this guide, you’ll learn exactly how your Delta Dental plan handles complete dentures, from plan types to costs, waiting periods and maintenance.
By the end, you’ll feel confident scheduling your next appointment without surprises.
Understand your coverage basics
Dentures, the artificial teeth you wear when natural ones are missing, typically fall under major services in dental plans.
Full upper and lower dentures replace all teeth on your upper and lower arches, restoring function and confidence when you smile or chew.
| Component | What it means |
|---|---|
| Plan type | The model of coverage you choose (PPO, copay or discount) |
| Annual maximum | The yearly cap your plan will pay for services |
| Deductible | The amount you pay out of pocket before coverage starts |
| Coinsurance | The percentage of costs your plan covers after you meet the deductible |
| Waiting period | The time you wait before certain services are covered |
Let’s be honest, if you don’t know these basics, you could run into unexpected bills.
Explore denture plan options
Delta Dental offers three main ways to cover your dentures. Your state, budget and comfort with set fees versus flexible cost sharing can shape which plan makes the most sense.
PPO individual plans
- Available in AL, CA, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, TX, UT, WV and DC
- You choose any dentist, but in-network providers lower your out-of-pocket costs
- After your deductible, the plan typically pays 50% of major services up to your annual maximum
DeltaCare USA plans
- Available in CA, FL, MD, NV, NY, PA, TX, UT and DC
- Copay model with fixed fees for each procedure
- No deductible or annual maximum, but you must stay in the DeltaCare USA network
Discount plans (Patient Direct)
- Not insurance but a fee-discount plan that gives you reduced rates at participating dentists
- No waiting periods, no paperwork
- You pay the discounted fee at the time of service
Review waiting period details
Here’s the thing, even the best plan won’t help if you need work right away but you’re stuck in a waiting period.
Major service waiting periods
- Restorative services like fillings or simple extractions often have 6 to 12 months of waiting
- Major services, including full dentures, typically carry a 12-month wait
Copay plan waiting periods
- DeltaCare USA sets its own waiting rules based on procedure
- Immediate dentures may be covered from day one, but conventional dentures could require a healing period of 6 to 8 weeks
Discount plan timing
- If you enroll in a discount plan like Patient Direct, your savings kick in right away
Estimate your out-of-pocket costs
Even with coverage, you’ll share the expense for full dentures, so it pays to estimate what comes out of your pocket.
- Deductible: usually $50 to $100 per person per year
- Coinsurance rate: PPO plans often cover 50% of major services
- Annual maximum: most individual plans cap benefits at $1,000 to $2,000
- Dentist fees: costs vary by region and provider
These figures are illustrative; check your plan details for exact amounts.
| Cost factor | Example range |
|---|---|
| Deductible | $50 – $100 |
| Coinsurance (PPO) | 50% after deductible |
| Annual maximum | $1,000 – $2,000 |
| Copay (DeltaCare) | Varies by procedure |
Choose in-network providers
When you pick a dentist who’s already in your plan’s network, you’ll pay less.
That’s because in-network providers agree to discounted fees.
- Visit Delta Dental’s online directory and filter for providers near you
- Call the office to confirm they accept your plan before you book
- Ask about their experience fitting full dentures
For a list of docs that accept dentures covered by Delta Dental for seniors, check out dentures covered by Delta Dental for seniors.
File your denture claim
Here’s a quick run-down of how to get your benefits.
- Confirm your coverage details and waiting periods
- Get preauthorization for major services if your plan requires it
- After treatment, ask your dentist to submit the claim electronically or give you an itemized receipt
- If you submit yourself, fill out the Delta Dental claim form and attach your receipt
- Track your claim status online or by phone, then schedule any follow up
You don’t need your ID card at the office, but having your member ID handy can speed up claim submission and questions.
Care for your dentures
Your new dentures deserve a little TLC.
- Remove and brush them every night with a soft denture brush and cleanser
- Soak in a cleaning solution or plain water to keep them from drying out
- Avoid harsh cleaners or boiling water to prevent warping
- Handle with care to avoid chips or cracks
- See your dentist every six months for check-ups and adjustments
Treat them like your favorite shoes and keep them clean, dry and protected from damage.
Summarize next steps
- Review your plan documents to confirm coverage details
- Reach out to your dentist to discuss treatment options and costs
- Check your waiting period before scheduling
- Get your Delta Dental member ID or print a digital card
- Bookmark this guide and share it with fellow retirees or caregivers
Have questions or tips about dentures coverage? Drop a comment below so fellow retirees can learn from your experience.
