Does Delta Dental Cover Root Canals? Here’s What You Need to Know

By Dr. Mason Haddow

Yes, Delta Dental does cover root canals in most of its plans.

A root canal can save your tooth, but can your insurance save you money?

Root canals are one of the most common restorative dental procedures, but they come with a reputation: they’re not only nerve-wracking but also potentially costly. If you’re Delta Dental covers you likely ask: Will it help cover the cost?

In this post, we’ll break down how Delta Dental handles root canal coverage. From PPO plans to DeltaCare USA, we’ll explore how much is typically covered, what to expect financially, and smart steps to take if you’re left with more out-of-pocket expenses than expected.

Key Takeaways

✔ Delta Dental typically covers root canals under major or basic restorative services

✔ PPO plans cover 50–80%, while DeltaCare USA uses flat copays

✔ Molars often receive lower coverage than front teeth

✔ Crowns and post-treatment work are billed separately

✔ Use pre-treatment estimates, HSA/FSA accounts, and payment plans to manage costs smartly

What Is a Root Canal and Why Might You Need One?

A root canal is a procedure that treats infection or damage deep inside a tooth. When the pulp (the soft tissue containing nerves and blood vessels) becomes infected due to decay or trauma, a root canal is often the only way to save the tooth.

Common reasons you might need a root canal:

Deep decay
Cracked or chipped tooth
Repeated dental procedures on the same tooth
Infection or abscess

The goal is to clean out the infected pulp, disinfect the area, and seal the tooth to prevent further damage. It’s a restorative treatment, not cosmetic—which is important when it comes to insurance.

Does Delta Dental Cover Root Canals?

Yes, Delta Dental does cover root canals in most of its plans. However, how much is covered—and how it’s covered—depends on:

Your specific plan type (PPO vs DeltaCare USA)
Which tooth needs the treatment (front teeth vs molars)
Whether you’ve met your deductible
The plan’s annual maximum or copay schedule

In general:

PPO plans cover 50% to 80% of the cost
DeltaCare USA plans to assign a fixed copay per tooth

Let’s look deeper into both options.

Coverage Breakdown by Plan Type

1. Delta Dental PPO Plans

Root canals are typically classified under basic or major restorative services in Delta Dental PPO plans.

What to expect:

Coverage: 50% to 80% depending on the tooth and your plan
Deductible: Must be met before coverage kicks in (usually $50–100)
Waiting period: 6 to 12 months for new members in some plans
Annual maximum: Most plans cap annual benefits at $1,000 to $2,000

Example:

A root canal on a front tooth (anterior): 80% covered
A root canal on a molar: 50% covered

Pre-treatment estimates are strongly recommended, especially if you’re unsure what category your root canal falls under.

2. DeltaCare USA (HMO Plans)

DeltaCare USA plans to use a copayment schedule rather than percentage-based coverage. The copay depends on the type of tooth:

Anterior teeth (front): $200–$250
Premolars: $250–$300
Molars: $300–$350

What to know:

Must use an in-network provider
No waiting periods
Predictable pricing, but less flexibility in provider or treatment types

If you’re unsure which plan you have, check your Schedule of Benefits or ask your provider’s office to verify it for you.

Are Root Canals on Molars Covered Differently?

Yes, they often are.

Molars are more complex to treat and tend to be reimbursed at a lower percentage in PPO plans. DeltaCare USA plans to assign a higher copay to molars compared to front teeth.

Be sure to:

Confirm which tooth is being treated
Ask your dentist to specify it in the insurance claim
Use a pre-treatment estimate for cost clarity

What Additional Costs Might Apply?

The root canal is just one part of the picture. You may also be billed for:

X-rays and diagnostics
Core buildup or post (to support the crown)
Crown placement, which is typically billed separately
Sedation or anesthesia (not always covered)
Follow-up exams

Crown coverage is often limited by time and plan maximums. So, plan accordingly.

What If Your Root Canal Isn’t Covered in Full?

Even if your insurance doesn’t cover everything, you have options.

1. Ask for a Pre-Treatment Estimate

Before you start treatment, ask your dentist to submit a pre-authorization or estimate. This outlines exactly what Delta Dental will cover and what you’ll owe.

2. Explore Alternatives Based on Tooth Type

Depending on your oral health, you may qualify for alternatives such as extraction and a bridge or implant. It’s not always ideal, but it’s good to know your choices.

3. Use HSA or FSA Funds

Root canals are 100% eligible expenses under Health Savings Accounts and Flexible Spending Accounts.

4. Look Into Payment Plans

Premier Image Dentistry offers flexible payment options so you don’t have to delay essential care.

5. Evaluate Your Plan

If you’re planning more extensive dental work, consider a PPO plan with a higher annual maximum during open enrollment.

How Much Does a Root Canal Cost With and Without Insurance?

Without Insurance:

Front tooth: $700–$1,100
Premolar: $800–$1,300
Molar: $1,000–$1,600

With Delta Dental PPO:

Front tooth: Covered at 80% = You pay ~$200–$300
Molar: Covered at 50% = You pay ~$600–800

With DeltaCare USA Copay:

Flat fee based on tooth type: ~$200–$350 per root canal

Note: Crowns and build-ups are additional and billed separately.

Tips for Maximizing Root Canal Coverage

Use an in-network provider to lower your out-of-pocket costs
Confirm the tooth classification (anterior, premolar, molar)
Submit supporting documentation with claims to prove medical necessity
Schedule treatment around annual benefit resets if you’re nearing your cap

Need a Root Canal in Lathrup Village, MI?

At Premier Image Dentistry, we perform gentle, precise root canal therapy with advanced technology and a focus on comfort.

We work with both Delta Dental PPO and DeltaCare USA plans and will:

Verify your coverage before treatment
Submit pre-treatment estimates upon request
Help you plan financially with flexible payment options

Book your consultation today and protect your smile the smart way.

Final Thoughts

So, does Delta Dental cover root canals? Yes but not always in full. It all depends on your plan type, tooth classification, and whether you’ve met your deductible or maxed out your benefits.

Root canals are critical to saving your natural teeth. Don’t let uncertainty over insurance delay your treatment. Work with your dentist, ask questions, and take proactive steps to understand your coverage.