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: 00361
Effective Date: 01/01/2025
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
Deductible (Individual/Family)
$0/$0
Plan Maximum
$2,500 per individual
Preventive Care
$0.00
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,000 per individual
Out-of-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$1,500 per individual
Preventive Care
$0.00
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,000 per individual
Plan Documents
Important Contacts
DeltaCare USA Dental HMO
Plan Information
Plan Name: DeltaCare USA Dental HMO
Policy Number: Pending
Effective Date: 01/01/2025
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
Deductible (Individual/Family)
$0/$0
Plan Maximum
Unlimited
Preventive Care
$5-$45 copay (varies by services; see contract for fee schedule)
Basic Services
$5-$90 copay (varies by services; see contract for fee schedule)
Major Procedures
$5-$195 copay (varies by services; see contract for fee schedule)
Orthodontia (Adults and Children)
$1,700-$1,900 copay (varies by services; see contract for fee schedule)
Plan Documents
Year Carrier Plan Document Name
