Complete Guide to Delta Dental PPO Insurance for Pediatric Dentistry at Hardy Pediatric Dentistry & Orthodontics

Are you searching for a pediatric dentist in Erie, CO that accepts Delta Dental PPO insurance? At Hardy Pediatric Dentistry & Orthodontics, we understand that navigating dental insurance for your child can be overwhelming. That’s why we’ve created this detailed guide to help you understand Delta Dental PPO coverage for pediatric dentistry and how our specialized team can provide exceptional care for your child’s smile.

Understanding Delta Dental PPO Plans for Children’s Dental Care

Delta Dental offers several PPO plans that provide coverage for pediatric dentistry services. Each plan offers different levels of coverage to meet your family’s needs and budget. Let’s explore the options available:

Delta Dental PPO Individual Basic Plan

The Delta Dental PPO Individual Basic Plan provides essential coverage for your child’s dental needs:

• Preventive Care: Your child receives approximately 100% coverage for essential preventive pediatric dental services with no waiting period
• Diagnostic Services: Full coverage for x-rays and other diagnostic procedures from day one
• Basic Treatments: Coverage for tooth fillings and simple extractions begins after a 6-month waiting period at an estimated 50% coverage
• Teeth Cleaning: Covered twice per calendar year with no waiting period

This plan is perfect for families looking for fundamental coverage at an affordable rate while ensuring their children receive regular preventive care.

Delta Dental PPO Individual Premium Plan

The Premium Plan offers enhanced coverage for more comprehensive pediatric dental care:

• Preventive Care: Immediate 100% coverage for essential preventive pediatric dental services
• Lower Out-of-Pocket Costs: Reduced expenses for most procedures compared to the Basic Plan
• Expanded Coverage: Dental fillings and root canals are available after a 6-month waiting period at an estimated 80% coverage
• Orthodontic Benefits: One set of post-treatment retainers for kids is typically covered for a lifetime
• Teeth Cleaning: Covered twice per calendar year with no waiting period

This plan is ideal for families who anticipate their children needing more than just preventive care and want greater financial protection.

Delta Dental PPO Plus Premier

The Delta Dental PPO Plus Premier plan combines two powerful networks to give your child the greatest flexibility:

• Expanded Network: Combines both Delta Dental PPO and Delta Dental Premier networks for more provider options
• Contracted Fee Benefits: Even if your Delta Dental Premier pediatric dentist isn’t part of the PPO network, your child still benefits from the dentist’s contracted fee
• Diagnostic Coverage: Bitewing x-rays covered twice per calendar year for children under 18
• Full Mouth X-rays: Covered once every 5 years
• Basic Services: Amalgam and synthetic fillings estimated at 80% coverage after a 6-month waiting period
• Teeth Cleaning: Covered twice per calendar year with no waiting period

This plan offers the most flexibility for families who may need to see specialists or want the widest possible network of providers.

What Pediatric Dental Services Does Delta Dental PPO Cover?

Preventive and Diagnostic Services

Delta Dental PPO plans provide excellent coverage for preventive and diagnostic care, which forms the foundation of your child’s oral health:

Preventive care is essential for catching potential issues early and establishing good oral hygiene habits that will benefit your child throughout their life.

Basic Restorative Services

When your child needs treatment beyond preventive care, Delta Dental provides coverage for common procedures:

• Tooth Fillings: Covered at 50% with Basic Plan and 80% with Premium Plan and PPO Plus Premier after a 6-month waiting period
• Simple Extractions: Coverage begins after 6 months
• Emergency Pain Relief: Available for unexpected dental emergencies

At Hardy Pediatric Dentistry & Orthodontics, Dr. Namrata Hardy specializes in gentle, child-friendly approaches to restorative care, including advanced laser dentistry that often eliminates the need for shots or drills.

Specialized Pediatric Dental Procedures

For more complex pediatric dental needs, coverage varies by plan:

• Frenectomy: Delta Dental may cover part of frenectomy procedures depending on your specific plan
• Tongue Tie and Lip Tie Correction: Coverage varies by plan, but many Delta Dental PPO plans provide partial coverage
• Laser Dentistry: Coverage for these innovative, less-invasive procedures varies by plan

At Hardy Pediatric Dentistry & Orthodontics, we’re proud to offer laser dentistry with Dr. Nam, currently the only dentist in Colorado that we’re aware of offering this high-tech treatment that creates a drill-free and shot-free experience for treating cavities.

Orthodontic Coverage Under Delta Dental PPO Plans

Many parents wonder about orthodontic coverage for their children. The good news is that Delta Dental PPO plans often include some orthodontic benefits:

• Retainers: With Delta Dental PPO Premium Plan, one set of post-treatment retainers is typically covered for a lifetime
• Braces and Aligners: Coverage for orthodontic treatment varies by plan, with some plans covering a percentage of traditional braces, clear braces, or Invisalign
• Annual Maximums: Most plans have annual or lifetime maximums for orthodontic treatment

At Hardy Pediatric Dentistry & Orthodontics, our orthodontist Dr. T.C. Hardy offers a variety of orthodontic treatment options, including traditional braces, KLOwen braces, InBrace, clear braces, and Invisalign® and Invisalign Teen® clear aligners.

Why Choose Hardy Pediatric Dentistry & Orthodontics for Your Child’s Delta Dental PPO Coverage?

Our practice in Erie, CO offers several advantages for families with Delta Dental PPO insurance:

• Specialized Care: Our team is led by board-certified specialists in pediatric dentistry and orthodontics
• Advanced Technology: We utilize laser dentistry, digital x-rays, iTero scanners, and 3D printing for more comfortable, precise care
• Combined Expertise: Having both pediatric dentistry and orthodontics under one roof means seamless coordination for your child’s complete oral health
• Comfortable Environment: Our office is designed to make children feel comfortable and reduce dental anxiety
• Insurance Expertise: Our team is experienced in maximizing Delta Dental benefits to reduce your out-of-pocket costs

Dr. Namrata Hardy is a Diplomate of the American Board of Pediatric Dentistry and a fellow of the American Academy of Pediatric Dentistry, ensuring your child receives the highest standard of care.

Frequently Asked Questions About Delta Dental PPO Coverage

How do I know which Delta Dental PPO plan is best for my child?

Choosing the right plan depends on your child’s specific dental needs and your budget. If your child typically only needs regular check-ups and cleanings, the Basic Plan may be sufficient. However, if your child has had cavities in the past or might need orthodontic work, the Premium Plan or PPO Plus Premier could provide better coverage. Our office team can help evaluate your child’s needs and discuss which plan might offer the best value for your family.

Are there waiting periods for my child to receive treatment under Delta Dental PPO?

Yes, Delta Dental PPO plans typically have waiting periods for certain services. While preventive care like cleanings and x-rays are covered immediately, basic services such as fillings usually have a 6-month waiting period. More complex procedures might have longer waiting periods. It’s important to enroll in a plan before your child needs extensive treatment to ensure coverage will be available when needed.

Does Delta Dental PPO cover specialized pediatric services like frenectomies for tongue ties?

Delta Dental may cover part of specialized procedures like frenectomies, tongue tie correction, or lip tie surgery depending on your specific plan. Coverage percentages vary, and some plans may classify these as basic or major procedures, affecting your out-of-pocket costs. At Hardy Pediatric Dentistry & Orthodontics, we can verify your specific coverage for these specialized treatments and discuss any potential costs before proceeding with treatment.

How often can my child get x-rays under Delta Dental PPO coverage?

Under most Delta Dental PPO plans, bitewing x-rays are covered twice in a calendar year for children under 18, while full mouth x-rays are typically covered once every five years. These frequencies align with recommended preventive care guidelines for children, allowing your dentist to monitor development and catch potential issues early. Dr. Nam uses digital x-ray technology that reduces radiation exposure by up to 90% compared to traditional x-rays.

Can I use my Delta Dental PPO insurance for both my child’s dental care and orthodontic treatment at Hardy Pediatric Dentistry & Orthodontics?

Yes! One of the advantages of our practice is that we offer both specialized pediatric dentistry and orthodontic care under one roof. Your Delta Dental PPO insurance can be applied to both types of treatment, though coverage percentages and maximums will vary by plan. Having everything in one location not only simplifies insurance processing but also ensures coordinated care between Dr. Nam and Dr. T.C. Hardy for optimal results.

Schedule Your Child’s Visit Today

Don’t wait to give your child the specialized dental care they deserve. At Hardy Pediatric Dentistry & Orthodontics, we’re proud to accept Delta Dental PPO insurance and work with you to maximize your benefits.

📍 Visit Us: 3200 Village Vista Dr., Suite 110, Erie, CO 80516
📞 Call: (720) 764-6158
📩 Or Request an Appointment Online Today at www.hardypedoortho.com

DISCLAIMER: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information, please see the insurance company’s website or call the customer service or member services number listed on most insurance ID cards. Updated as of April 28, 2025. The above logo & trademarks are property of Delta Dental.