Dental
Plan/Group Number 05479
(888) 335-8227
Keep your smile looking its brightest with the help of dental coverage provided through the Delta Dental Preferred Option (PPO) Plan. Our Plan allows you to see any licensed dentist, but the Plan pays increased benefits when you use a Delta Dental PPO dentist.
Under the Delta Dental Plan, you can use any licensed dentist, but your out-of-pocket costs will be lower when you use Premier dentists and will be the lowest when you use PPO dentists. If you use non-Delta dentists, you’re responsible for your percentage share, plus any amounts the dentist charges above the usual, customary, and reasonable (UCR) rate.
Before getting treatment for more than $300, have your dentist submit a predetermination of benefits to Delta Dental so you’ll know how much your plan will pay and the portion you’ll be responsible for.
Delta Dental PPO Dentists* | Delta Dental Premier Dentists* | Non-Delta Dental Dentists* | |
---|---|---|---|
Deductible | None | $50 per person / $100 per family each calendar year | $50 per person / $100 per family each calendar year |
Benefit Maximum | $2,500 | $2,500 | $2,500 |
Diagnostic and Preventive Services (exams, cleanings, X-rays, sealants) | 100% | 100% | 100% |
Basic Services (fillings, simple tooth extractions, night guards) | 90% | 80% | 80% |
Major Services (crowns, inlays, onlays and cast restorations, bridges and dentures, implants) | 60% | 50% | 50% |
Orthodontic Benefits | 50% | 50% | 50% |
Orthodontic Maximum | $2,500 Lifetime | $2,500 Lifetime | $2,500 Lifetime |
* Reimbursement is based on PPO contracted fees for PPO dentists, Premier contracted fees for Premier dentists, and program allowance for non-Delta Dental dentists.
Did Your Dentist Drop Delta?
If your dentist no longer accepts Delta Dental insurance, you can search for a new in-network provider by visiting Delta Dental.