Dental Coverage
Two Dental Options
You are able to choose dental coverage under one of the following plans:
- Delta Dental Plus
- Delta Dental Basic
If you choose, you may elect to waive dental coverage.
Delta Dental Plus provides coverage for preventive, restorative, major, orthodontic, and TMJ services. This option may be right for you if you want the higher level of coverage provided by this option and you’re willing to pay the higher premiums for this coverage.
Delta Dental Basic provides coverage for preventive and restorative services only. As a result, your premiums are lower for this coverage.
How the Options Compare
Benefit
Plans
Click plan
Type >
- Delta Dental Plus
- Delta Dental Basic
Plan Feature
Calendar Year Deductible
$50 individual
($100 family maximum)
($100 family maximum)
Preventive Services
(includes x-rays, regular exams and cleanings twice in a calendar year, and fluoride treatments for children under age 19 once in a calendar year and sealants on approved teeth for children under age 16)
(includes x-rays, regular exams and cleanings twice in a calendar year, and fluoride treatments for children under age 19 once in a calendar year and sealants on approved teeth for children under age 16)
100% of MAA*,
no deductible
no deductible
Restorative Services
(includes restorations, simple extractions, adjustment, repair, and relining of removable appliances, root canal therapy, periodontal scaling, root planing and osseous surgery)
(includes restorations, simple extractions, adjustment, repair, and relining of removable appliances, root canal therapy, periodontal scaling, root planing and osseous surgery)
80% of MAA,
after the deductible
after the deductible
Major Services
(includes fixed or removable appliances – complete dentures, partial dentures, bridgework, onlays, crowns, and implants)
(includes fixed or removable appliances – complete dentures, partial dentures, bridgework, onlays, crowns, and implants)
50% of MAA,
after the deductible
after the deductible
Orthodontic Services
50% of MAA,
no deductible
no deductible
Temporomandibular Joint (TMJ) Disorder Treatment Services
50% of MAA,
no deductible
no deductible
Individual Maximum Calendar Year Benefit
(excludes orthodontic and TMJ benefits)
(excludes orthodontic and TMJ benefits)
$1,700
Individual Orthodontic Lifetime Maximum Benefit
$1,700
Individual TMJ Lifetime Maximum Benefit
$1,700
Plan Feature
Calendar Year Deductible
$50 individual
($100 family maximum)
($100 family maximum)
Preventive Services
(includes x-rays, regular exams and cleanings twice in a calendar year, and fluoride treatments for children under age 19 once in a calendar year and sealants on approved teeth for children under age 16)
(includes x-rays, regular exams and cleanings twice in a calendar year, and fluoride treatments for children under age 19 once in a calendar year and sealants on approved teeth for children under age 16)
100% of MAA*,
no deductible
no deductible
Restorative Services
(includes restorations, simple extractions, adjustment, repair, and relining of removable appliances, root canal therapy, periodontal scaling, root planing and osseous surgery)
(includes restorations, simple extractions, adjustment, repair, and relining of removable appliances, root canal therapy, periodontal scaling, root planing and osseous surgery)
80% of MAA,
after the deductible
after the deductible
Major Services
(includes fixed or removable appliances – complete dentures, partial dentures, bridgework, onlays, crowns, and implants)
(includes fixed or removable appliances – complete dentures, partial dentures, bridgework, onlays, crowns, and implants)
no coverage
Orthodontic Services
no coverage
Temporomandibular Joint (TMJ) Disorder Treatment Services
no coverage
Individual Maximum Calendar Year Benefit
(excludes orthodontic and TMJ benefits)
(excludes orthodontic and TMJ benefits)
$1,000
Individual Orthodontic Lifetime Maximum Benefit
n/a
Individual TMJ Lifetime Maximum Benefit
n/a
* MAA – Maximum Allowable Amount