Dental
Taking care of your oral health is not a luxury; it is a necessity for long-term optimal health. With a focus on prevention, early diagnosis, and treatment, Dental insurance can greatly reduce your costs when it comes to restorative and emergency procedures.
When you visit a dentist in the network, you will maximize your savings. These dentists have agreed to reduced fees, which means you won’t get charged more than your expected share of the bill.
Delta Dental PPO
Plan Information
Plan Name: Delta Dental PPO
Policy Number: 22635
Effective Date: 01/01/2025
Provider Network: Delta Dental Premier
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Deductible (Per Individual)
$50/$150
Plan Maximum
$2,000
Preventive Care
$0
Basic Services
10%
Major Procedures
40%
Orthodontia (Adults and Children)
Not Covered
Out-of-Network
Deductible (Per Individual)
$50/$150
Plan Maximum
$2,000
Preventive Care
$0
Basic Services
10%
Major Procedures
40%
Orthodontia (Adults and Children)
Not Covered
Plan Documents
Contact Information
DeltaCare Dental HMO
Plan Information
Plan Name: DeltaCare Dental HMO
Policy Number: 79748
Effective Date: 01/01/2025
Provider Network: Delta Dental
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Preventive Care
$0
Basic Services
Fee schedule
Major Procedures
Fee schedule
Orthodontia (Adults and Children)
Copayments for each phase of orthodontic treatment is listed in fee schedule.
Comprehensive treatment (first 24 months):
$1,700 copay (child up to 19)
$1,900 copay (adult)
Out-of-Network
Preventive Care
$0
Basic Services
Fee schedule
Major Procedures
Fee schedule
Orthodontia (Adults and Children)
Copayments for each phase of orthodontic treatment is listed in fee schedule.
Comprehensive treatment (first 24 months):
$1,700 copay (child up to 19)
$1,900 copay (adult)