A growing number of dental providers across the country are rethinking their participation in traditional PPO networks, especially Delta Dental. Once considered a necessary part of practice growth, insurance plans like Delta Dental are now facing scrutiny from frustrated dentists who feel squeezed by stagnant reimbursements, rising overhead, and excessive red tape. In 2025, the trend of dentists dropping PPO plans is accelerating, and it’s changing the way dental care is delivered and paid for in the U.S.
Why Dentists Are Leaving PPOs
1. Low Reimbursement Rates
Delta Dental and many PPOs have not kept pace with inflation or the rising cost of dental materials and labor. In fact, many dentists report being reimbursed less than what they were paid a decade ago for the same procedures. This leaves practices with difficult choices: cut corners, raise fees for non-covered patients, or leave the plan altogether.
2. Rising Overhead Costs
Dental supply costs have skyrocketed in recent years, along with staffing costs. At the same time, insurance reimbursements remain flat, or worse, are being cut. When providers do the math, many realize they’re operating at a loss on some PPO patients.
3. Administrative Burden
PPO participation often brings excessive paperwork, delayed payments, frustrating preauthorization requirements, and frequent claim denials, among other headaches. Dentists are increasingly frustrated with the time and resources it takes to chase down payments or fight denied claims.
Real Numbers Behind the Trend
Here are a few statistics that help illustrate this shift:
- In a 2023 ADA survey, 1 in 5 dentists reported plans to drop at least one insurance network within the next two years.
- Over 30% of dentists in solo practices say they are limiting PPO participation or considering transitioning to fee-for-service only.
- In states like California and Illinois, Delta Dental has been the subject of class-action lawsuits over unfair reimbursement practices and unilateral contract changes.
What Happens When Dentists Drop PPOs?
When dentists leave PPO networks like Delta Dental:
- Patients may be asked to pay upfront and receive reimbursement later
- Practices may introduce in-house membership plans or partner with discount plan networks
- Dentists regain control over pricing, treatment decisions, and patient communication
While leaving a major PPO may seem risky, many providers report increased profitability and job satisfaction after making the switch, especially when paired with transparent alternative solutions for patients.
What It Means for Employers and Patients
As more dentists opt out of PPOs, patients are left with fewer in-network options, and employers will continue paying high per-employee-per-month (PEPM) premiums and ASO fees for shrinking access. When offering dental insurance, most employers can only afford plans with low annual maximums ($1,000-$1,500), long waiting periods for major procedures, and no transparency around provider quality.
This is causing both patients and employers to rethink whether traditional dental insurance is still worth it.
Alternatives Gaining Momentum
Employers and providers are now exploring other options such as the following:
Dental Savings Programs
Instead of insurance, these programs provide pre-negotiated discounts on care, with no annual caps or claims to file.
Employer-Sponsored Membership Plans
Dentists offer affordable monthly memberships directly to patients or through employer groups. These plans typically include preventive care and offer discounts on major procedures, including those not usually covered by traditional dental insurance.
FSA and HSA Integration
Some employers are opting to contribute directly to employee FSAs or HSAs, giving them freedom to choose any provider, regardless of network.
Final Thoughts
The exodus from PPOs like Delta Dental is real, and it’s gaining steam. Dentists are tired of being undervalued, and patients are tired of limited access and surprise bills. For forward-thinking employers and dental providers, now is the time to explore better alternatives that support both quality care and financial sustainability.
Dentists & Employers:
Are you frustrated with Delta Dental and other PPOs? Contact DenScore’s Head of Partnerships at kyle@denscore.com to learn about a smarter alternative that delivers more value to dentists, employers, and employees alike.
