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Inside Delta Dental · HMO vs PPO

DeltaCare USA vs Delta Dental PPO

Both say "Delta" on the card, but they are opposite products. One gives you fixed copays and no annual maximum with an assigned dentist. The other lets you see any dentist and pays a share up to a yearly cap. Here is how to tell which one you have, and which one to pick.

Is DeltaCare USA the same as Delta Dental PPO?
No. They are two different products, not two tiers of one plan. DeltaCare USA is a dental HMO: you use one assigned network dentist, pay a fixed copay per service, get a referral for specialists, and have no deductible and no annual maximum, but no coverage outside the network. Delta Dental PPO lets you see any dentist, pays coinsurance after a deductible up to an annual maximum, and needs no referral, with the biggest savings at an in-network dentist. The HMO is built for low, predictable cost. The PPO is built for choice. CoverCapy sells neither, so this comparison has no thumb on the scale.
A dental HMO like DeltaCare USA has no annual dollar maximum, so it never stops paying at $1,000 or $2,000 the way a PPO can. The trade is that you use one assigned network dentist. Source: Delta Dental, DeltaCare USA plan details, verified July 2026.
Side by side

DeltaCare USA HMO vs Delta Dental PPO

The same eight questions, answered for each product. Exact numbers vary by state and plan; these are the rules that hold across most plans.

What mattersDeltaCare USA (HMO)Delta Dental PPO
How you payFixed copay per serviceCoinsurance after a deductible
DeductibleNoneUsually yes, around $50
Annual maximumNoneUsually yes, for example $2,000 on the Premium tier
Choose your dentistOne assigned network dentistAny dentist, save most in network
Specialist accessReferral from your dentistNo referral needed
Out of networkNot covered except emergenciesOften partly reimbursed
Typical premiumLow, quote-based by stateHigher, about $75/mo on the individual Premium tier
Best forLowest, most predictable costAny-dentist freedom and big-ticket work

DeltaCare USA individual plans are sold in CA, FL, MD, NV, NY, PA, TX, UT and DC. Copays come from a state-specific schedule, for example an exam at $0, a cleaning at $5 to $20, and a crown at $125 to $495. Premium plan figures are from the individual Delta Dental PPO Premium tier and vary by state, age and ZIP.

Two tools, two jobs

Which one fits you

Neither is better. They solve different problems. Pick the one that matches how you use dental care.

Choose the HMO when

DeltaCare USA fits you

  • A low, steady monthly premium matters most.
  • You want to know the exact copay before you go, with no deductible and no annual cap.
  • You expect a lot of work in one year and do not want a plan that stops paying at a maximum.
  • You are comfortable using one assigned network dentist and getting a referral for specialists.
  • You live in a state where it is sold.
Choose the PPO when

Delta Dental PPO fits you

  • You want to keep or freely choose your own dentist.
  • You may go out of network and still want partial coverage.
  • You want to see a specialist without a referral.
  • You value the largest dentist network in the country.
  • You will use the annual maximum on crowns, implants or other major work.
Two-minute check

Which one fits you? Answer four questions

A guide, not advice. Your plan and state set the exact rules.

1. How much do you want to keep or choose your own dentist?
2. Do you expect major work this year (crown, implant, several fillings)?
3. What matters more to you?
4. Do you want to see a specialist without a referral?

Answer all four to see which product leans your way.

Leans toward

At work

Your employer may default you to the HMO

Employers often list the DHMO first because it has the lowest premium. If you would rather choose your own dentist, a PPO option may be one question away.

Many benefit menus include both a DeltaCare USA HMO and a Delta Dental PPO. The HMO looks cheaper on the enrollment screen, so it is easy to pick by default. You can ask whether a PPO option exists and what it adds per paycheck before you decide.

Ask your benefits contactDoes our dental menu include a PPO option, and what is the per-paycheck difference between it and the DeltaCare USA plan?
How Delta employer plans work
On Medicare

The SCAN example: HMO now, PPO if you buy up

Medicare Advantage shows the same choice one layer up. SCAN Health Plan is a clear case.

On many SCAN plans the standard dental benefit is included at no extra premium and runs on the DeltaCare USA network: an assigned dentist and set copays. If you want to keep your own dentist, SCAN sells an optional dental PPO buy-up for an added premium that moves you to the Delta Dental Medicare Advantage PPO network, lets you see any provider, and carries no annual limit on covered services. You have two months after your SCAN membership begins to add the buy-up. Specific copays and any allowances vary by plan and county, so confirm yours in the Evidence of Coverage.

Seniors and Medicare

See the Medicare and SCAN options

What the SCAN Delta benefit covers, who it fits, and how to find a Delta dentist for it.

Delta Dental for seniors

Common questions

Is DeltaCare USA the same as Delta Dental PPO?
No. They are two different products. DeltaCare USA is a dental HMO: you use one assigned network dentist, pay fixed copays, get a referral for specialists, and have no deductible or annual maximum, but no out-of-network benefit. Delta Dental PPO is a preferred-provider plan: you can see any dentist, pay coinsurance after a deductible up to an annual maximum, and need no referral. The HMO trades dentist choice for low, predictable cost; the PPO trades a higher premium for any-dentist freedom.
Does DeltaCare USA have an annual maximum?
No. A dental HMO like DeltaCare USA has no annual dollar maximum and no deductible. You pay a set copay per service instead of coinsurance, so the plan does not stop paying at $1,000 or $2,000 the way a PPO can. Delta Dental PPO plans do have an annual maximum, for example $2,000 on the individual Premium tier.
Which is cheaper, DeltaCare USA or Delta Dental PPO?
DeltaCare USA usually has the lower monthly premium and fixed copays, so its cost is predictable. Delta Dental PPO costs more per month, for example about $75 on the individual Premium tier, but lets you keep your own dentist and use an annual maximum on major work. Which is cheaper for you depends on how much care you need and whether you want to choose your dentist.
Can I switch from DeltaCare USA to a Delta Dental PPO?
Often, depending on who sponsors your plan. Many employers let you choose a PPO option during open enrollment or when you are newly hired. Some Medicare Advantage carriers such as SCAN include DeltaCare USA at no extra cost and sell an optional PPO buy-up for an added premium. Check your Evidence of Coverage or ask your benefits contact.
Do I need a referral with DeltaCare USA?
Yes. With DeltaCare USA your assigned primary care dentist coordinates your care and refers you to a network specialist when needed. Delta pre-approval is not required, and specialist services carry up to a 25 percent discount. A Delta Dental PPO needs no referral, and you can see a specialist directly.
Keep researching

Next in the Delta guide

Networks

PPO vs Premier vs DeltaCare

All three Delta networks and how each one pays.

 Plans

Individual PPO plans

Premium vs Basic tiers, cost, and what each covers.

 Medicare

Delta Dental for seniors

SCAN, the PPO buy-up, and finding a dentist.
CC
Reviewed July 2026 by the CoverCapy Editorial Team, checked against Delta Dental and SCAN plan documents.
CoverCapy is an independent guide. We sell neither insurance nor dental plans and are paid by the dental offices we verify, so the answer has no thumb on the scale.
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Transparency

Sources and last reviewed

Checked against official Delta Dental and SCAN materials on July 2, 2026. Product rules vary by plan and state; confirm yours before enrolling.

Delta Dental, DeltaCare USA HMO dental plan for individuals · deltadentalins.com
Delta Dental, DHMO vs PPO: what's the difference · deltadental.com
Delta Dental PPO individual plans · deltadentalins.com
SCAN Health Plan, Delta Dental benefit and optional PPO buy-up · scanhealthplan.com