Upcoming Changes with Delta Dental
Important Information for Our Patients
Beginning January 1, 2027, our office will no longer be in-network with Delta Dental. We understand that this change may bring up questions about your insurance benefits, costs, and whether you can continue receiving care at our office. We created this FAQ to answer the questions we are hearing most often and to help make the transition as simple as possible.
The Most Important Thing to Know
You do NOT need to find a new dental office. Being out-of-network does not mean that we cannot work with your dental insurance. You can continue receiving your dental care with us, and our team will continue to submit claims on your behalf and help you make the most of your available benefits. We would love to continue caring for you and your family.
Why We’re Making This Change
Why is your office leaving the Delta Dental network?
This was not a decision we made lightly. We have participated with Delta Dental for many years and are grateful for the relationship we have had. Over time, however, Delta Dental’s reimbursement has remained relatively stagnant while the costs of providing high-quality dental care have continued to increase. Remaining in-network has made it increasingly difficult to provide care in the way we believe is best for our patients.
Going out-of-network gives us greater freedom to continue investing in our team, technology, materials, and the time we spend with our patients while maintaining the quality and standard of care you have come to expect from us.
We understand that seeing an in-network dentist may reduce out-of-pocket costs for some patients. At the same time, many patients choose to continue with a dental team they know and trust because they value consistent care, high-quality materials and technology, individualized treatment recommendations, and continuity with doctors and a team who know their dental history.We believe choosing a dentist involves more than insurance participation, and we are committed to helping you understand both your treatment and its cost before making decisions about your care.
Continuing Your Care With Us
Can I still come to your office if you are out-of-network?
Absolutely! You do not need to find a new dentist simply because we are out-of-network with your insurance. You can continue receiving your dental care with us, and we will continue to submit insurance claims on your behalf and help you make the most of your available benefits. Think of “out-of-network” as a change in the relationship between our office and the insurance company, not a change in the relationship between you and our office. We already care for many patients with out-of-network insurance benefits and look forward to continuing to care for you and your family.
What does “out-of-network” mean?
Being out-of-network simply means that our office does not have a contract with your insurance company that determines the fees we are allowed to charge. It does not mean that we cannot accept or bill your insurance. If you have a PPO dental plan with out-of-network benefits, your insurance may still pay toward your care at our office.
Are you currently in-network with Delta Dental?
Yes, we are currently in-network with Delta Dental. However, beginning January 1, 2027, we will no longer be an in-network Delta Dental provider, but you can still use your Delta Dental benefits at our office. We will continue to submit your claims to Delta Dental on your behalf and help you understand your available benefits.
What dental insurance plans do you accept?
Beginning in 2027, our office will be out-of-network with all dental insurance plans, but we can still work with most PPO plans and submit claims on your behalf. In fact, we already work with nearly 30 dental insurance plans as an out-of-network provider, and many of our patients have been using their PPO benefits with us this way for years.
Being out-of-network does not mean you cannot use your dental insurance at our office. If you are unsure about your specific plan, please contact us and we’ll be happy to help.
What if my employer offers another PPO dental plan?
You are welcome to ask us about it. Because we already work with many PPO dental plans as an out-of-network provider, you may still be able to use your benefits at our office. When comparing plans, we recommend looking at the plan’s out-of-network benefits, deductible, annual maximum, covered services, and reimbursement levels, in addition to whether a dentist is in-network. Our team can help explain how a plan may work at our office, but the final choice of insurance is always yours.
Understanding Your Costs & Benefits
How much will I have to pay out of pocket? Will my costs increase?
Your out-of-pocket cost will depend on your individual insurance plan, its out-of-network benefits, and the treatment you receive.
Depending on your plan and treatment, your insurance reimbursement may be lower than it was when we were in-network. However, our office fees are not increasing simply because we are going out-of-network. What may change is how much your insurance company pays toward your treatment.
For planned treatment, we can submit a pre-treatment estimate (sometimes called a pre-authorization) to your insurance company. This gives us a better idea of what your insurance is expected to pay and what your estimated portion will be.
Please remember that insurance estimates are not a guarantee of payment or coverage. Your final benefit is determined by your insurance company when the claim is processed.
Will Delta Dental still cover my cleanings?
Many Delta Dental plans provide out-of-network benefits for cleanings, examinations, X-rays, and other preventive services. The amount Delta Dental pays will depend on your individual plan.
Our team will be happy to review your benefits and provide an estimate whenever possible.
Can you check my insurance benefits before I have treatment?
Yes. Our team can review your insurance benefits and provide an estimate whenever possible.For planned treatment, we may also submit a pre-treatment estimate to your insurance company to get a better idea of what they are expected to pay and what your estimated portion will be.Please remember that insurance companies do not guarantee payment based on an estimate. Your final benefit is determined when the claim is processed.
Will I have to pay the full amount upfront?
We do not anticipate requiring you to pay the entire treatment fee upfront simply because we are out-of-network. Beginning January 1, 2027, California’s new AB 1629 requires applicable dental plans to honor a patient’s request to assign eligible insurance benefits directly to an out-of-network dental office.
In simple terms, this means your insurance payment can be sent directly to our office instead of to you, allowing us to generally collect only your estimated patient portion at the time of service. This is especially helpful for our Delta Dental patients as we transition out of the Delta network in 2027. Learn more about AB 1629 from the California Dental Association
For State of California Employees
Should I choose Delta Dental or MetLife during Open Enrollment?
You can continue receiving your dental care with us whether you choose Delta Dental or MetLife. Beginning in 2027, our office will be out-of-network with both plans, but we can continue to bill your insurance and help you use your available benefits. If you are considering a change, we encourage you to consider either MetLife Core or MetLife Plus.
Based on the information available to us, MetLife may provide more favorable out-of-network reimbursement for some services. However, your actual benefits and out-of-pocket costs will depend on the plan you select and the treatment you receive.If you prefer to stay with Delta Dental, that is absolutely okay. You do not need to switch to MetLife in order to continue seeing us. With AB 1629 taking effect January 1, 2027, eligible insurance benefits can be assigned directly to an out-of-network dental office. This means assignment of benefits should not be the deciding factor between Delta Dental and MetLife anymore. When comparing your options, we recommend reviewing the plans’ premiums, deductibles, annual maximums, covered services, and out-of-network benefits. Our team is also happy to help explain how a plan may work at our office.
Preparing for 2027
Do I need to do anything before January 1, 2027?
If you are happy with your current insurance, you do not need to change plans simply because our office is going out-of-network. If you have an upcoming Open Enrollment period and have multiple PPO options available, this is a good opportunity to compare their out-of-network benefits.Most importantly, you do not need to find another dental office. We would love to continue caring for you and your family.