The Downtown Seattle Dentist Accepts Delta Dental PPO & Premier Insurance

If you have Delta Dental coverage through your employer, a federal employee plan, Medicare Supplement, or an individual plan, you can use your benefits at The Downtown Seattle Dentist.

Accepted Plans:

Delta Dental PPO, Delta Dental Premier, Federal Dental Plans, Medicare Supplement Dental Plans

Plans we’re not currently able to accept:

Delta Dental HMO (DeltaCare USA), Medicaid dental plans

*If you’re unsure which plan type you have, call us and we’ll look it up for you.

The Downtown Seattle Dentist accepts Delta Dental PPO and Delta Dental Premier dental insurance. We take care of the insurance process so you can focus on your visit. Our team confirms your Delta Dental plan details and coverage before your first appointment, provides written cost estimates ahead of any major procedure, and submits your claims electronically after every visit. Any follow-up with Delta Dental is handled entirely by our billing team.

Network Status:

In-Network with Delta Dental PPO & Delta Dental Premier

Typical Delta Dental PPO Coverage at a Glance

Coverage percentages below reflect typical Delta Dental PPO and Premier benefit levels for employer-sponsored plans in Washington State. Your exact coverage depends on your specific plan, deductible status, and remaining annual maximum, all of which we confirm before any treatment is scheduled.

Service Category	Typical Coverage	Common Examples
Preventive & Diagnostic Care	80% – 100%	Exams, cleanings, X-rays, fluoride treatments, sealants
Basic Restorative Services	70% – 80%	Fillings, simple extractions, emergency palliative visits
Major Restorative Services	50%	Crowns, bridges, root canal therapy, dentures
Periodontal (Gum) Treatment	50% – 80%	Scaling & root planing, periodontal maintenance
Oral Surgery	50%	Surgical extractions, wisdom teeth removal
Orthodontics (if benefit elected)	20% – 50%	Invisalign, traditional braces (lifetime ortho max applies)
Dental Implants	Varies by plan	Implant placement, abutment & crown (employer plan determines)

Understanding Your Annual Delta Dental Maximum & Deductible

Annual Maximum

This is the total dollar amount Delta Dental will contribute toward your covered dental care within a single benefit year. Most employer-sponsored Delta Dental PPO plans carry an annual maximum between $1,000 and $2,500. Once that limit is reached, any remaining costs for the year are the patient's responsibility.

Deductible

This is the amount you pay out-of-pocket before Delta Dental begins contributing to covered services. A typical Delta Dental PPO deductible is $50 to $100 per person. Preventive care, including exams and cleanings, is generally exempt from the deductible, meaning your coverage applies from your very first visit.

Frequency Limitations

Most Delta Dental PPO plans include frequency limits on certain services, such as one set of bitewing X-rays per year or cleanings every six months. Our team reviews these limits during your benefits verification so there are no surprises.

Delta Dental PPO Coverage by Dental Treatment

Our Seattle dental offices offer a full range of dental services that fall within Delta Dental's covered categories. We confirm your specific plan coverage and provide a detailed cost estimate before scheduling any procedure.

Dental Exam

Preventive — typically covered at 100%

Professional Teeth Cleaning

Preventive — typically covered at 100%

Digital X-Rays

Preventive — typically covered at 100%

Fluoride Treatment

Preventive — coverage commonly includes patients through age 18–21

Dental Sealants

Preventive — typically covered for children and adolescents

Cavity Treatment (Fillings)

Basic restorative — typically covered at 70–80%

Tooth Extractions

Basic restorative — typically covered at 70–80%

Emergency Dentistry

Basic restorative — palliative and emergency visits typically covered

Dental Crowns

Major restorative — typically covered at 50%

Dental Bridges

Major restorative — typically covered at 50%

Root Canal Therapy

Major restorative — typically covered at 50%

Dentures & Removable Appliances

Major restorative — typically covered at 50%

Gum Disease Treatment

Periodontal — typically covered at 50–80%

Periodontal Care (Deep Cleaning)

Periodontal — typically covered at 50–80%

Invisalign Clear Aligners

Orthodontic benefit (if elected) — typically 20–50% up to lifetime maximum

Pediatric Dentistry

Preventive & basic services — typically well covered under most plans

TMJ Treatment

Coverage varies by plan — we confirm your benefits before any treatment begins

Mouth Guards

Coverage varies — many plans provide partial coverage for prescribed appliances

Our Insurance Process

Get Started Using Your Delta Dental Insurance at our Seattle dental offices

Step 1

We Verify Your Delta Dental Benefits

Before your visit, our insurance team contacts Delta Dental directly to confirm your plan type (PPO or Premier), covered services, annual maximum, remaining deductible, frequency limitations, and any waiting periods. You'll receive a plain-language summary before your appointment.

Step 2

You Receive Your Care

Our clinical team provides the treatment you need at your chosen Seattle dental office. You pay your estimated patient portion on the day of service.

Step 3

We File Your Claim

After your visit, our billing team submits your Delta Dental claim electronically to your insurance provider. Most Delta Dental claims are processed within 10 to 30 business days, after which you'll receive an Explanation of Benefits (EOB) from Delta Dental.

Step 4

We Follow Up and Appeal on Your Behalf

Our team monitors your claim through processing and reviews your EOB when it arrives. If Delta Dental underpays, requests additional documentation, or issues a denial, we handle the follow-up and appeals process on your behalf. We work to make sure your Delta Dental plan pays what it should so you're not leaving benefits on the table.

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Delta Dental Dental Insurance FAQs

Is Delta Dental insurance accepted at The Downtown Seattle Dentist?

Yes — The Downtown Seattle Dentist is in-network with Delta Dental PPO and Delta Dental Premier plans, and that includes Federal employee and Medicare Supplement dental coverage. Delta Dental HMO (DeltaCare USA) and Medicaid dental plans are not accepted.

Does Delta Dental pay for a routine cleaning here?

In most cases, yes. Delta Dental PPO and Premier plans typically cover preventive care — exams and cleanings — at 80% to 100%, and these services usually aren't subject to the deductible. Our team confirms the details of your plan ahead of your appointment.

Will The Downtown Seattle Dentist submit my claim to Delta Dental for me?

Yes. Our billing staff electronically files every Delta Dental claim on your behalf right after your visit, so there's nothing for you to fill out or send in.

How do Delta Dental PPO and Delta Dental Premier plans differ?

PPO plans are built around a contracted fee schedule, whereas Premier plans rely on a maximum plan allowance structure. The Downtown Seattle Dentist accepts both. If you aren't sure which one you have, just give us a call and we'll check for you.

Are dental implants covered by Delta Dental at The Downtown Seattle Dentist?

It depends on the plan — implant benefits aren't universal. Some Delta Dental PPO and Premier plans include implant coverage while others exclude it, so we verify your exact benefit before scheduling an implant consultation.

What happens if my Delta Dental plan includes a waiting period on major work?

Waiting periods for major services differ from plan to plan. During your benefits verification, our team at The Downtown Seattle Dentist checks for any waiting period and lets you know before we schedule an affected procedure.