Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues.
Contact Information
Delta Dental
888-335-8227
deltadentalins.com
Delta Dental PPO
Benefit Highlights
PPO Dentists
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Individual/Family)
$2,000
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Individual/Family)
$2,000
Preventive Care
$0*
Basic Services
20% after deductible*
Major Services
50% after deductible*
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived*
Premier Dentists
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Individual/Family)
$2,000
Preventive Care
$0
Basic Services
20% after deductible
Major Services
50% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
* Reimbursement is up to the maximum contracted allowance.
Plan Cost - Bi-weekly
Employee Only: $0.00
Employee and Spouse: $18.72
Employee and Child(ren): $15.32
Employee and Family: $25.53