DUAL DENTAL PLAN (PPO)
We offer two dental plan to all eligible employees through Delta Dental. While you can visit any licensed dentist, your cost is lower when you visit a dentist in the Delta PPO or Premier network. Our carrier pays based on their fee schedule to out-of-network dental providers, so you could see a balance bill for any service provided by an out-of-network provider including preventive care.
See the chart below for the differences in coverage and benefit levels for in- and out-of network services. To obtain a list of providers in the network, visit www.deltadental.com or call 888-335-8227. Download the Delta Dental app from your smartphone app store, so you will have your coverage information at your fingertips. ID cards are not provided for Dental insurance.
* Delta Dental will only pay up to their contract allowances which may not be your dentist’s actual fees. You will be responsible for the difference or balance billing should you use providers outside the networks.
Value Added Benefits
Delta Dental’s coverage includes the SmileWay® Wellness Benefits option, which offers expanded coverage for those diagnosed with diabetes, heart disease, HIV/AIDS, rheumatoid arthritis, or stroke.
Visit https://dd.deltadentalins.com/brushsmart to receive a 20% discount on Philips Sonicare Products.
Expanded Coverage for Expecting Mothers: 1 additional exam; 1 additional cleaning or scaling, and root planning. Amplifon (hearing aid) and Qualsight (LASIK) discount.
Dental PPO Low Plan | Dental PPO High Plan |
|||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network |
|
| Annual Deductible Waived for preventive | $50/$150 | $$50/$150 | $50/$150 | $$50/$150 |
| Annual Max | $1,500 | $1,500 | $1,500 | $1,500 |
| Lab and Other Diagnostic Tests, Oral Exam/Bitewing, X-rays | 100% | 100% | 100% | 100% |
| Basic Services | ||||
| Periodontics, Endodontics, Simple Extractions, Fillings | 80% | 80% | 80% | 80% |
| Major Services | ||||
| Dentures, Removable, Prosthetics, Crowns | 50% | 50% | 50% | 50% |
| Orthodontia – Lifetime Maximum | ||||
| Child/Adult Coverage | $1,500 | $1,500 | $1,500 | $1,500 |
Dental DHMO |
|
|---|---|
In-Network Only |
|
| Annual Maximum Benefit | None |
Preventive | No Charge |
Basic, Major & Othro Services | Copays Vary |
Copay applies to each covered procedure. Refer to the Plan Schedule for copay amounts. | Copays Vary |
Q: Do I need to choose a dentist when I sign up for the DHMO?
A: Yes, you will need to choose a primary dentist. If you don’t choose one Delta Dental will auto assign you to a dentist within your zip code. You can find a network dentist at www.delta.com or call (800) 422-4234
Value Added Benefits
- Visit www.brushsmart.org to receive a 20% discount on Philips Sonicare Products
- Expanded Coverage for Expecting Mothers: additional exam; additional cleaning or scaling, and root planning
- LASIK discounts with QualSight: save up to 35%
- Hearing aids and discounts with Amplifon save an average of 66%
Ready to make the most of your membership. To get started visit Member Perks
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