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Dental Coverage

How the Plan Works

The dental plan, administered by Delta Dental, helps keep your teeth and mouth healthy by covering preventive care (cleanings and X-rays) at 100% and paying a portion of the cost for other types of care.

You pay less when you visit a Delta Dental PPO (DPPO) in-network dentist, and there’s no deductible to meet. Delta Dental offers one of the largest provider networks in the country, and you can choose to get care from:

  • A Delta Dental PPO dentist. You get the highest level of coverage and the lowest out-of-pocket costs when you see a Delta Dental PPO dentist.
  • A Delta Dental Premier dentist. You’ll pay more to see these dentists, but still get lower in-network rates.
  • An out-of-network dentist. You pay the most when you see an out-of-network dentist. You’ll also have to meet a deductible before the plan pays benefits, and file claims for reimbursement.

Nearly 80% of all dentists in the U.S. are members of the Delta Dental network. Check with your current dentist to see if he or she participates.

What You Pay for Care

  When You See a Delta Dental PPO Dentist When You See a Delta Dental Premier Dentist1 When You See an Out-of-Network Dentist1

Calendar-Year Deductible

$0

$50 Self

$150 Family

$50 Self

$150 Family

Calendar-Year Maximum (per member)

$1,500

$1,500

$1,500

Diagnostic and Preventive Care

Cleanings, exams, X-rays

$0

$0

$0

Basic Services

Anesthesia, root canals, simple and surgical extractions

10%

20%

20%

Major Services

Crowns, inlays, veneers, implants, bridges

10%

20%

20%

Orthodontia

For children and adults

50% plus any amount over the $1,000 lifetime maximum

50% plus any amount over the $1,000 lifetime maximum

50% plus any amount over the $1,000 lifetime maximum

1. In addition to any deductible and coinsurance, you are responsible for any billed charge that exceeds Delta Dental’s maximum allowed amount for services provided by an out-of-network provider.

Find a Dentist

Find an in-network provider or check coverage and costs at deltadentalins.com, or call (800) 765-6003 Monday through Friday, 5:00 a.m. to 5:00 p.m. (Pacific).

I.D. Cards

You won’t need to bring an ID card to your appointment. Just give your dentist your name, date of birth and Social Security number (or your enrollee number, which you’ll find under My ID card after logging in to the Dental Dental website). If you’re a dependent, provide these details for the primary enrollee.