Overview
Healthy teeth and gums are important to your overall health. That’s why it’s important to have regular dental checkups and maintain good oral hygiene.
With the dental plan, you get:
Free in-network preventive and diagnostic care,
including cleanings and X-rays.
Affordable coverage
that helps you manage the cost of dental treatment.
A wide network of providers
that have agreed to negotiated rates, which helps you save money.
Coverage Details
Here’s a brief overview of dental plan benefits with Delta Dental.
| Delta Dental: PPO Dentists* |
Delta Dental: Premier Dentists* |
Non-Delta Dental: Dentists* |
|
|---|---|---|---|
|
Deductible
(waived for preventive/diagnostic and orthodontia services)
|
$50/individual
$150/family |
$50/individual
$150/family |
$50/individual
$150/family |
| Preventive & Diagnostic Services
(exams, cleanings, X-rays, sealants, space maintainers) |
100% | 100% | 100% |
| Basic Services
(fillings, simple extractions, posterior composites, denture repair/reline/rebase) |
80% | 80% | 80% |
| Endodontics
(root canals) |
80% | 80% | 80% |
| Periodontics
(surgical and non-surgical) |
80% | 80% | 80% |
| Oral Surgery | 80% | 80% | 80% |
| Prosthodontics
(bridges, dentures) |
50% | 50% | 50% |
| Implants | 50% | 50% | 50% |
| Orthodontic Services
(adults and dependent children) |
50% | 50% | 50% |
* Reimbursement is based on the Delta Dental maximum contract allowances and not necessarily each dentist's submitted fees. Reimbursement is based on PPO contracted fees for PPO dentists, Premier contracted fees for Premier dentists, and the program allowance for non-Delta Dental dentists.
What's the difference in coverage for PPO, Premier, and non-Delta dentists?
Your provider options are:
- Delta Dental PPO dentists: To maximize your savings, use these providers. They've agreed to reduced fees and you won't get charged more than your expected share of the bill.
- Delta Dental Premier providers: If you can't find a PPO dentist, consider a Premier provider. Keep in mind, these dentists offer smaller discounts than PPO providers, so your costs will be higher.
- Non-Delta Dental dentists: If you use a dentist who is not affiliated with Delta Dental, your costs will be the highest. Plus, these providers may choose to “balance bill" you. This happens if your dentist charges more than the amount the insurance company pays. In this situation, your dentist may choose to bill you for the excess portion not covered by insurance.
Use Your Dental Benefits Wisely
Here’s how to make the most of your dental benefits:
Choose a provider.
Selecting a participating dentist in the dental plan's network will ensure you receive the highest benefits.
To find a provider, go to the Delta Dental website:
- From the top navigation, click Find a dentist.
- For the “network,” choose Delta Dental PPO for the highest level of coverage, or Delta Dental Premier for lower coverage.
If your service will exceed $200, submit for a pretreatment estimate.
You should always submit a request for a pretreatment estimate for procedures and services your dentist believes will exceed $200 (procedures such as crowns, inlays, bridges, and periodontics).
Check your claim status and other information at Delta Dental.
You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more.
Dental ID Cards
You will not receive a physical ID card for dental coverage, as it's not required to access services. However, if you'd like an ID card, you may download a copy online from Delta Dental.
Dental Plan Premiums
The chart below shows the paycheck deduction you will pay on a bi-weekly basis for your dental coverage.
| Enrollment Tier | PPO Dental Delta Dental |
|---|---|
| Employee Only | $2.88 |
| Employee + Spouse/DP* | $8.75 |
| Employee + Child(ren) | $10.87 |
| Family | $18.94 |
*Domestic partner premiums are subject to pre- and post-tax costs. In addition, imputed income will be assessed.