Does Aspen Dental Take Delta Dental Insurance?

Finding a dentist that fits your schedule, budget, and insurance plan can feel like a puzzle. If you have a Delta Dental insurance plan and an Aspen Dental office nearby, you are likely asking a very important question: Does Aspen Dental take Delta Dental insurance?

The short answer is yes, in the vast majority of cases. However, the relationship between a large dental service organization (DSO) like Aspen Dental and a giant insurer like Delta Dental has some nuances you need to understand. You don’t want to walk into an appointment only to find out you are paying more than you expected.

This guide will walk you through everything you need to know about using your Delta Dental insurance at Aspen Dental. We’ll cover how to verify your benefits, what to expect regarding coverage, and tips to ensure you get the most out of your visit.

The Short Answer: Yes, Aspen Dental Generally Accepts Delta Dental

To put your mind at ease right away: Aspen Dental officially accepts Delta Dental insurance at most of its locations across the United States. They are considered a participating provider in the Delta Dental network.

This means that if you walk into an Aspen Dental office with a valid Delta Dental card, the front desk staff will typically be able to file a claim on your behalf. You will receive the in-network discounts that Delta Dental has negotiated, which prevents you from being charged the full “retail” price for services.

However, there is a very important distinction to make here. “Accepting” insurance isn’t always the same as being “in-network” for every single type of Delta Dental plan.

Understanding the Difference: “Accepting” vs. “In-Network”

This is where things can get a little tricky. To ensure you aren’t hit with unexpected bills, you need to understand the two main ways dental offices handle insurance.

In-Network (Participating Provider)

When a dentist is “in-network” with Delta Dental, they have signed a contract. This contract states they will charge a specific, pre-negotiated fee for procedures. In exchange, Delta Dental encourages patients to visit these providers.

• Benefit: You pay the lowest possible out-of-pocket cost. The dentist writes off the difference between their normal fee and the negotiated rate.

Out-of-Network (Non-Participating Provider)

If a dentist is “out-of-network,” they haven’t signed that specific contract. However, they may still “accept” your insurance.

• Benefit: They will usually still file the claim for you, and Delta Dental will send you a payment based on their allowed amount.

• Downside: The dentist may charge a higher fee than what Delta Dental approves. You are responsible for paying the difference (this is called “balance billing”).

The Aspen Dental Scenario

Aspen Dental operates as a huge network of offices. Because of their size, they are almost always in-network with Delta Dental’s premier plans (like the Delta Dental PPO) . However, if you have a more restrictive plan (like a Delta Dental HMO or a Medicaid-specific plan), their participation status might differ.

The Golden Rule: Always assume that while they take the insurance, your specific plan type determines your final cost.

How to Verify Your Delta Dental Coverage at Aspen Dental

Don’t rely on guesswork. Here is a step-by-step guide to confirming your coverage before you ever sit in the dental chair.

Step 1: Check Your Insurance Card

Look at your physical or digital insurance card. You need to identify two things:

1. The Plan Type: Is it a PPO, an HMO, or a Premier plan? This is usually written in small print.

2. The Logo: Ensure it says Delta Dental. There are regional Delta Dental companies (like Delta Dental of California, Delta Dental of Michigan, etc.), but they all fall under the national umbrella.

Step 2: Use the Online Provider Search

Delta Dental’s website has a “Find a Dentist” tool. This is the most reliable way to verify network status.

• Go to the Delta Dental website specific to your state.

• Use the provider search tool and enter your zip code.

• Look for Aspen Dental in the results.

• Crucial Check: The listing should explicitly say if they are accepting new patients and if they are a “Participating Provider” for your specific plan.

Step 3: Call the Local Aspen Dental Office

While online research is great, a phone call provides the most certainty.

• Call the specific Aspen Dental location you plan to visit.

• Tell the receptionist: “I have a Delta Dental PPO plan. Can you confirm that you are currently in-network with my specific plan?”

• They may ask for your member ID to run a quick eligibility check. This is a standard and smart practice.

Important Note for Readers: Insurance networks can change. An office that was in-network last year might have renegotiated their contract. Always verify directly, even if you’ve been there before.

What to Expect During Your First Visit with Delta Dental

Once you’ve confirmed they accept your insurance, your first visit to Aspen Dental will follow a predictable pattern. Knowing this process helps reduce anxiety.

The New Patient Experience

Aspen Dental is known for making the first visit comprehensive. You will likely undergo:

• Welcome and Paperwork: You’ll fill out medical history forms and provide your Delta Dental card.

• Comprehensive Exam: A dentist will perform a full examination of your teeth, gums, and mouth. They often use digital X-rays and intraoral cameras.

• The “Dental Savings Finder”: This is Aspen Dental’s term for their treatment plan presentation. They will review the exam findings with you, show you images, and present a treatment plan. This plan will be broken down by cost, including what your Delta Dental insurance is expected to cover and what your portion will be.

How Billing Works

Because Aspen Dental is connected to Delta Dental’s system, they will usually:

1. Estimate your coverage: They will use software to estimate how much Delta Dental will pay for your cleaning, fillings, or other procedures.

2. Collect your portion: You will typically be asked to pay your estimated co-pay or deductible at the time of service.

3. File the claim: They will electronically submit the claim to Delta Dental on your behalf.

A Sample Cost Breakdown Table

To give you an idea of how the numbers work when using an in-network provider like Aspen Dental, look at this example for a patient who has met their annual deductible.

*As you can see, being in-network with Delta Dental at Aspen Dental saved this patient $130 off the retail price before insurance even paid their share.*

Common Delta Dental Plans and How They Work at Aspen Dental

Not all Delta Dental plans are created equal. Here is how the most common types interact with Aspen Dental.

Delta Dental PPO

• Status: Almost always in-network.

• Pros: You get the highest level of benefits and the lowest out-of-pocket costs. You don’t need a referral to see a specialist (if referred by Aspen Dental).

• Cons: You may have a deductible to meet and an annual maximum cap on benefits (usually between $1,000 and $2,500).

Delta Dental Premier

• Status: Usually in-network, but it works differently.

• How it works: Premier is a “fee-for-service” network. Delta Dental sets a maximum fee they will pay for a procedure, but the dentist (Aspen Dental) may charge up to that amount.

• The Result: You will likely have no balance billing issues, but your out-of-pocket costs might be slightly higher than under a PPO plan because the fee structure is different.

DeltaCare USA (DHMO)

• Status: This is the tricky one. Many Aspen Dental locations do NOT participate in DHMO plans because they require patients to choose a primary care dentist from a very limited list and often pay the dentist a fixed monthly rate per patient rather than per procedure.

• What to do: You must check the DeltaCare USA provider directory specifically. If Aspen Dental is not listed there, they cannot see you under this plan, though they might offer you a cash discount or their own membership plan instead.

Delta Dental Medicaid/CHIP

• Status: Varies drastically by state.

• What to do: Some Aspen Dental locations are state-contracted providers for government dental plans, while others are not. You must call the office and ask specifically, “Do you accept Delta Dental Medicaid in [Your State]?”

What If Aspen Dental Doesn’t Take My Delta Dental Plan?

Let’s say you call and discover that your specific Delta Dental HMO plan isn’t accepted. This isn’t the end of the road. You have options.

1. The Aspen Dental Membership Plan

Aspen Dental offers an in-house savings plan. This is not insurance, but a discount program.

• How it works: You pay an annual fee (often broken into monthly payments). In return, you get significant discounts (often 50% or more) on all dental procedures.

• Best for: People without insurance, or those whose insurance isn’t accepted. You can often use this immediately, with no waiting periods for major work.

2. Explore Other Local In-Network Dentists

Delta Dental has a massive network. If the Aspen Dental near you isn’t a fit for your specific plan, Delta Dental’s website can help you find another general dentist or specialist in your area who is.

3. Appeal or Switch Plans

If you are committed to Aspen Dental and have a PPO plan that isn’t working, ask your HR department (if you have employer coverage) if there is a different Delta Dental product available during the next open enrollment period. You may be able to switch to a plan that Aspen Dental participates in more favorably.

Tips to Maximize Your Delta Dental Benefits at Aspen Dental

You pay for your insurance premiums, so you should get the most out of them. Here’s how to do that at Aspen Dental.

• Use Your Preventive Care: Most Delta Dental plans cover 100% of preventive care (cleanings, exams, X-rays) twice a year. Schedule these appointments. Skipping them leads to bigger problems (and costs) later.

• Understand Your “Maximum”: Delta Dental typically pays up to a certain dollar amount per year (e.g., $1,500). If you need major work like crowns or dentures, try to schedule it early in the year. If you wait until November, you might run out of benefits.

• Don’t Delay Treatment: If the dentist finds a small cavity, get it filled now. Waiting until next year could mean the cavity grows, requiring a more expensive root canal or crown, which will eat up more of your benefits.

• Ask for a Pre-Determination: If your dentist recommends a costly procedure (like a bridge or implants), ask the front desk to submit a “pre-determination” or “pre-authorization” to Delta Dental. This gives you a written estimate of what the insurance will pay before you commit to the work. Aspen Dental is usually very proactive about doing this for patients.

Frequently Asked Questions (FAQ)

Q: Do I need to call Delta Dental first or Aspen Dental first?
A: Call the Aspen Dental office directly. They have the most up-to-date information on their own participation status and can run an eligibility check for you immediately.

Q: Will Aspen Dental bill Delta Dental directly?
A: Yes. As an in-network provider, they will handle the insurance paperwork and bill Delta Dental directly. You are only responsible for paying your estimated co-pay, coinsurance, or deductible at the time of service.

Q: I have two insurance plans (e.g., Delta Dental and a spouse’s plan). Can I use both at Aspen Dental?
A: Yes, this is called “coordination of benefits.” Provide both insurance cards to the Aspen Dental office when you check in. Their billing department will handle the coordination to maximize your combined coverage.

Q: Does Aspen Dental accept Delta Dental for emergency visits?
A: Yes. If you have a toothache or a broken tooth, Aspen Dental usually offers same-day emergency appointments. Your Delta Dental emergency coverage should apply just as it would for a regular visit, provided you are at an in-network location.

Q: What if I have an old Delta Dental card?
A: Insurance changes every year. Make sure you provide the current year’s insurance card. If you have a 2023 card in 2024, your coverage may be invalid or different.

Conclusion

To put it simply, Aspen Dental and Delta Dental are a common and compatible pair. In most situations, Aspen Dental is an in-network provider for Delta Dental PPO and Premier plans, which means you can walk in with confidence knowing your insurance will work to lower your costs.

The key to a stress-free experience is verification. Don’t assume—take five minutes to call your local Aspen Dental office or use Delta Dental’s online directory to confirm your specific plan. By doing that small bit of homework, you unlock access to affordable, comprehensive dental care with the convenience of a national provider.

Summary: Aspen Dental generally accepts Delta Dental insurance as an in-network provider for most PPO plans. However, coverage can vary based on your specific plan type, such as an HMO or state-specific Medicaid. Always verify your benefits directly with your local Aspen Dental office before your appointment to ensure accurate cost estimates.

Additional Resource

To find a Delta Dental provider in your area or to learn more about your specific plan benefits, visit the official Delta Dental website: www.deltadental.com