Health Plans & Support
Dental
Overview
Dental benefits are provided through Delta Dental. You have these options:
Low DPPO
Low Dental Preferred Provider Organization
High DPPO
High Dental Preferred Provider Organization
Deltacare USA (DHMO)*
Dental Health Maintenance Organization
*Available depending on where you live
All Plans:
Pay 100% for preventive care
Provide coverage for preventive, basic, major care and orthodontia
How Are the Plans Different?
Low and High DPPO
- Allow you to see any dentist but offer savings when you use a Delta Dental network provider
- You meet the deductible (except for preventive care) and then pay a percentage of the cost
- The High DPPO provides a higher level of benefits than the Low DPPO, so the premiums are higher
Deltacare USA DHMO
- Must use a DeltaCare USA network provider (no out-of-network coverage)
- There’s no deductible to meet
- You pay a fixed fee according to the patient charge schedule
Find A Provider
Dental Plans at a Glance
Here’s a look at what you’ll pay when you receive dental care.
| LOW DPPO | HIGH DPPO | DELTACARE USA (DHMO) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK ONLY | ||||||
| Deductible (what you pay first for some services) | ||||||||||
| Individual | $50 | $50 | $50 | $50 | None | |||||
| Family | $150 | $150 | $150 | $150 | None | |||||
| Annual Benefit Maximum (the most the plan will pay in a calendar year) | ||||||||||
| Individual/Family | $1,250 | $1,250 | $1,500 | $1,500 | No maximum | |||||
| Orthodontia Lifetime Maximum | ||||||||||
| Per person | $1,500 | $1,500 | $3,000 | $3,000 | No maximum | |||||
| You Pay | ||||||||||
| Diagnostic & Preventive (exams, cleanings, X-rays) | $0, no deductible | 10%, no deductible | $0, no deductible | 10%, no deductible | $0 for routine cleaning, X-rays, oral exams | |||||
| Basic (fillings, extractions, oral surgery) | 20% after deductible | 30% after deductible | $0 after deductible | 10% after deductible | Set fee based on patient charge schedule | |||||
| Major (crowns, bridges, dentures, implants) | 50% after deductible | 60% after deductible | 20% after deductible | 30% after deductible | Set fee based on patient charge schedule | |||||
| Orthodontia (children and adults) | 50% after deductible | 60% after deductible | 20% after deductible | 30% after deductible | Set fee based on patient charge schedule | |||||
Costs for Coverage
Here are your biweekly costs for dental coverage.
| COVERAGE TIER | LOW DPPO | HIGH DPPO | DELTACARE USA (DHMO)* |
|---|---|---|---|
| Associate | $9.00 | $15.00 | $5.00 |
| Associate + 1 | $17.00 | $31.00 | $12.00 |
| Associate + Family | $23.00 | $47.00 | $18.00 |
*Available in certain locations
FAQs
Will I get a dental ID card?
For the Low and High DPPO, you will not receive a dental ID card, but you can print one from the Delta Dental website. For the DHMO, you will receive an ID card.
Do I need a referral to see a specialist?
That depends on which dental plan you choose.
- Low and High DPPO: No referral is needed to see a specialist. Remember you’ll save money if you use a provider in the Delta Dental network.
- DHMO: Your network general doctor will refer you to a specialist in the network. You can also contact Delta Dental for a referral.
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