Delta Dental
- https://www1.deltadentalins.com
- 800-521-2651
- $2,000 or $2,500 benefit coverage
- Two preventive basic cleanings each year at no cost
- Basic and major dental services coverage
- Providers nationwide on the Delta Dental PPO and Premier networks
- Orthodontia benefits on the Dental Plus plan
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Dental (2000) Summary Plan Description | Dental Plus (2500) Summary Plan Description | |||
---|---|---|---|---|
Services | Contracted Dentist | Non-Contracted Dentist | Contracted Dentist | Non-Contracted Dentist |
Preventive | ||||
Routine exams, cleanings (2 per year), topical fluoride, x-rays, space maintainers, sealants | 100% | 100% of R&C | 100% | 100% of R&C |
Basic | ||||
Composite fillings, extractions, oral surgery, endodontics, periodontics (No Waiting Period) | 80% | 80% of R&C | 80% | 80% of R&C |
Major | ||||
Crowns, bridges, dentures, surgical implants (No Waiting Period) | 50% | 50% of R&C | 50% | 50% of R&C |
Orthodontics | ||||
Lifetime Maximum | No Benefit | No Benefit | $2000 | $2000 |
Maximum Benefit (Applies to Basic and Major Services Per Benefit Period) | ||||
Benefit Period is Per Calendar Year | $2,000 | $2,500 | ||
Deductible (Per Benefit Period) | ||||
Per Person: Family Maximum: | $50.00 $150.00 | $50.00 $150.00 | $50.00 $150.00 | $50.00 $150.00 |
Specialists Endodontists, Oral Surgeons, Pediatric, Periodontists, Prosthodontists | ||||
Contracted Specialist payment: |
| |||
Non-contracted Specialist payment: | Paid the same as non-contracted dentists |
2024 | Full Time | Part Time |
---|---|---|
Monthly | Monthly | |
Dental (2000) | ||
Single | $10 | $20 |
Two party | $22 | $35 |
Family | $29 | $45 |
Dental Plus (2500) | ||
Single | $28 | $40 |
Two party | $64 | $102 |
Family | $86 | $127 |
2024 | ||
---|---|---|
Dental 2000 (Cost per month) | ||
Employee | $36 | |
Employee + 1 Child | $81 | |
Employee + Spouse | $81 | |
Employee + Children | $107 | |
Employee + Family | $107 | |
Dental Plus 2500 (Cost per month) | ||
Employee | $48 | |
Employee + 1 Child | $109 | |
Employee + Spouse | $109 | |
Employee + Children | $147 | |
Employee + Family | $147 |
Did you have services with a non-Delta Dental provider?
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Delta Dental