Dental

Our dental plans encourage early detection of dental problems by paying the most toward diagnostic and preventive services, such as routine check-ups and cleanings. You will get a Delta Dental ID card in the mail.

Dental Plan

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Dental Plan

	Enhanced Plan		Basic Plan
Dental Plan	In-Network	Out-of-Network	In-Network	Out-of-Network
Annual Deductible*	$50 Individual / $150 Family		$75 Individual / $25 Family
Calendar Year Maximum*	$1,500		$1,000
Reimbursement Levels	Based on negotiated fees	90% of usual and customary after deductible	Benefit reimbursement for all dentists is based on the Delta Dental PPO allowed network fees
Class I: Preventive & Diagnostic	No charge		No charge
Class II: Basic Restorative Care	10% after deductible	10% after deductible	20% after deductible	20% after deductible
Class III: Major Restorative Care	50% after deductible	50% after deductible	50% after deductible	50% after deductible
Class IV: Orthodontia	50% up to $1,500 lifetime maximum per child Available to children under age 26		No Ortho
Orthodontia Lifetime Maximum	$1,500		No Ortho
* Annual deductible and calendar year maximums reset every January 1. Any expenses that have already been incurred toward your deductible and maximums will continue to accumulate until January 1 of the following year.

Example of Your Copayment

Delta Dental PPO: Lowest out-of-pocket costs and network protection.
Delta Dental Premier: Higher out-of-pocket costs than PPO, but may be lower than non-network and network protection.
Non-network: You may have the highest out-of-pocket costs.

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