Dental Benefits
Keep your smile healthy with dental coverage through Delta Dental.
Plan Details
| Feature | In Network | Out Of Network |
|---|---|---|
| Individual Deductible | $50 | $50 |
| Family Deductible | $150 | $150 |
| Calendar Year Maximum (per person) | $1,500 | $1,500 |
- Feature
- Individual Deductible
- In Network
- $50
- Out Of Network
- $50
- Feature
- Family Deductible
- In Network
- $150
- Out Of Network
- $150
- Feature
- Calendar Year Maximum (per person)
- In Network
- $1,500
- Out Of Network
- $1,500
Covered Services (Member Pays)
Percentages shown reflect the portion you (the member) pay after the deductible.
| Feature | In Network | Out Of Network |
|---|---|---|
| Preventive Services | 0% | 0% |
| Basic Services | 20% | 20% |
| Major Services | 50% | 50% |
| Orthodontia | 50% | 50% |
- Feature
- Preventive Services
- In Network
- 0%
- Out Of Network
- 0%
- Feature
- Basic Services
- In Network
- 20%
- Out Of Network
- 20%
- Feature
- Major Services
- In Network
- 50%
- Out Of Network
- 50%
- Feature
- Orthodontia
- In Network
- 50%
- Out Of Network
- 50%
Plan Notes
- Deductible is waived for Preventive Services and Orthodontia
- Annual Calendar Year Maximum: $1,500 per person
- Orthodontics Lifetime Maximum: $1,500
Plan Contact
Delta Dental