Health Plan Options :: Delta Dental

Principal Benefits and Covered Services

• Deductibles & Benefit Maximums: $50 per person, $150 per family per calendar year. The maximum benefit paid per calendar year is $2500 per person.
• Diagnostic and Preventive Benefits: 100% of Delta dentist's fee (no deductible applies for these services).
• Basic Benefits: 80% of Delta dentist's fee.
• Prosthodontic Benefits: 50% of Delta dentist's fee (subject to maximum allowance) (bridges, dentures).
• Orthodontic Benefits: 80% of Delta dentist's fee (subject to a $2500 lifetime maximum per person)
  

How to receive care

Under the DeltaPremier USA program you may visit any licensed dentist of your choice, change dentists at any time, go to a dental specialist of your choice, and receive dental care anywhere in the world. Following are some of the advantages of choosing a Delta dentist:

• Claim forms are completed and submitted for you at no charge. Your dentist's fees have been certified by Delta as usual,
  customary and reasonable - you're responsible only for the patient share.
  
• You may be charged only your copayment and deductible at the time of treatment, not Delta's portion.
  

If you choose a non-Delta dentist, you may have to complete and submit your own claim forms or pay a service fee; Delta has not certified the dentist's fees and you are responsible for the difference if your dentist charges more than Delta's preapproved fees; and you may have to pay the entire bill at the time of treatment and wait for reimbursement.

About your Delta Dental ID card

Two ID cards will be issued after you are enrolled in the plan. Your ID card will have your group name and number, your name and your Social Security Number. The card is for information purposes only and Delta dentists do not require you to show an ID card. You can see a Delta dentist before you receive your ID card. Just give your dentist your Delta Dental group number (805) and your Social Security Number.