If you’re exploring restorative dentistry covered by Delta Dental, you’ll find that major procedures like crowns and bridges receive partial reimbursement under many plans. We know that navigating your insurance can feel daunting, especially when budgeting for restorative work as you age. This guide walks you through Delta Dental’s coverage for seniors, so you can confidently plan procedures—from fillings to full-arch implants—while minimizing out-of-pocket costs.
Understand Delta Dental coverage
When it comes to restorative dental care, your specific Delta Dental plan determines what’s covered, how much you pay, and when benefits reset. Familiarizing yourself with plan structures and enrollment rules sets the foundation for smart treatment planning.
Plan types and tiers
Delta Dental offers several plan designs, each with its own network, cost structure, and coverage levels:
- Delta Dental PPO
- Access to a broad network of in-network dentists
- Lower fees when you stay in network
- Delta Dental DHMO
- Predefined copayments for each procedure
- No annual maximums but limited provider choices
- Delta Dental Advantage Plans
- Graduated benefits that increase with plan tenure
- Ideal for retirees in employer-sponsored retiree programs
Each plan organizes benefits into tiers:
- Preventive care (exams, cleanings) often covered at 100%
- Basic restorative (fillings, simple extractions) commonly covered at 70–80%
- Major restorative (crowns, bridges, dentures, implants) typically covered at 50% or more after waiting periods
Eligibility and enrollment
Your eligibility for senior-specific coverage hinges on plan type and employer arrangements:
- Employer retiree plans – you may enroll in a group PPO or Advantage Plan
- Individual retiree plans – available through select state exchanges or private brokers
- Open enrollment periods – usually in the fall, check your benefits calendar
- Special enrollment – qualifying life events (retirement, loss of coverage) can trigger off-cycle enrollment
Review your plan documents or contact Delta Dental directly to confirm deadlines and required paperwork.
Explore covered restorative procedures
Delta Dental’s restorative dentistry benefits can make a significant difference in both your oral health and wallet. Below is an overview of common procedures and how they’re generally covered.
Fillings and inlays
Basic restorative work like fillings and inlays restores decayed or fractured teeth with materials such as composite resin or porcelain:
- Coverage level
- Most PPO plans cover 70–80% after your deductible
- DHMO copays typically range from $10 to $50 per filling
- Common uses
- Repairing small cavities
- Strengthening weak tooth structure
If you’re comparing options, you can also see how UnitedHealthcare handles similar care in our guide on UHC covered dental fillings for seniors.
Dental crowns and onlays
Crowns and onlays protect teeth that are extensively damaged or have undergone root canal therapy. Standard coverage details:
- Materials covered
- Porcelain fused to metal, all-ceramic, and gold crowns (depending on plan)
- Benefit levels
- PPO plans often cover 50% of crown costs after the deductible
- Advantage Plans may require a waiting period before major service benefits kick in
For specifics on porcelain restorations, see porcelain crown replacement covered by delta dental.
Bridges and dentures
Replacing one or more missing teeth preserves bite alignment and overall oral health. Delta Dental typically covers:
- Fixed bridges
- Anchored to adjacent teeth, bridging a gap
- Coverage around 50% after deductible
- Removable partial and full dentures
- Acrylic or metal base options
- Major service benefits apply
Learn more about denture options and coverage in our article on dentures covered by delta dental for seniors.
Implants and associated services
Dental implants offer a durable solution for missing teeth, but they involve multiple phases and associated procedures:
- Implant placement
- Major service benefits usually cover 50% of implant costs after waiting periods
- Abutments and crowns
- Often billed separately; crown coverage aligns with major restorative tier
- Bone grafts and sinus lifts
- Coverage varies by plan, sometimes subject to medical necessity reviews
For a deep dive into implant benefits, check delta dental dental implant coverage for seniors.
All-on-4 implants
All-on-4 full-arch restoration combines multiple implants and a fixed prosthesis. As a complex procedure, it often requires:
- Pre-authorization
- Documentation of medical necessity
- Benefit review under major services
See details in delta dental all-on-4 implant coverage.
Estimate your out-of-pocket costs
Knowing how deductibles, coinsurance, maximums, and waiting periods interact helps you forecast your expenses.
Deductibles and coinsurance
- Deductibles
- Amount you pay before Delta Dental begins sharing costs
- Separate deductibles may apply for basic versus major services
- Coinsurance
- Your share of allowed fees after meeting the deductible
- Expressed as a percentage (for example, 50% coinsurance on crowns)
Annual maximum benefits
- Defined annual cap
- Dollar limit on the insurer’s payments in a benefit year
- Once reached, you pay 100% of additional charges
- Reset schedule
- Typically resets on January 1 or your plan anniversary date
Waiting periods
- Basic services
- Often no waiting period for fillings and simple extractions
- Major services
- Common 6- to 12-month waiting period before coverage for crowns, bridges, and implants begins
- Waivers
- Some plans waive waiting periods if you had prior coverage within a specific timeframe
Find in-network providers
Staying in network translates to lower fees and smoother claims processing. Delta Dental’s network includes 3 out of 4 dentists nationwide.
Using the Find a Dentist tool
- Visit Delta Dental’s website or member portal
- Select your plan type and location
- Filter by specialty (for example, restorative dentistry or prosthodontics)
- Review provider profiles for office hours and accepted payment methods
Tips for selecting dentists
- Experience with senior care and complex restorations
- On-site imaging or sedation services if needed
- Patient reviews and satisfaction ratings
- Office accessibility for mobility concerns
Maximize your plan benefits
Smart planning and proactive coordination can stretch your coverage further.
Pre-treatment estimates
- Request a free pre-treatment estimate in writing
- Typical processing time: 10–14 business days when all information is provided
- Clarifies what Delta Dental will pay and what you owe before starting treatment
Secondary coverage coordination
- If you carry a secondary or supplemental policy
- Submit primary claim to Delta Dental first
- Secondary insurer covers remaining eligible expenses
Timing treatments strategically
- Schedule major procedures early in the benefit year to use full annual maximum
- Combine visits when possible to reduce repeated deductible and coinsurance charges
- Plan preventive care visits first to maximize periodontal health before restorative work
Plan your next steps
Armed with knowledge of your restorative dental benefits, you can take clear action toward healthier teeth and gums.
Reviewing your benefit summary
- Locate your Evidence of Coverage (EOC) document
- Confirm benefit percentages, deductibles, annual maximums, and waiting periods
- Note important deadlines and enrollment windows
Contacting Delta Dental support
- Member services phone number on your ID card
- Online chat or email via the member portal
- Ask about pre-authorizations and any required clinical documentation
Exploring alternative resources
If you need to compare other carriers or plans, check our guides on in-network restorative dental care with Cigna and restorative dentist accepting bcbs insurance.
By understanding your Delta Dental coverage and leveraging tools like pre-treatment estimates and the Find a Dentist resource, you can restore function and confidence to your smile without unexpected costs. Take the next step by reviewing your plan details or contacting Delta Dental today—your smile deserves a plan as reliable as you are.
