| Your Cost | ||
|---|---|---|
| DENTAL NETWORK | Delta Dental PPO & Premier | |
| PREVENTIVE SERVICES | Routine exams, cleanings, X-rays | 100% |
| DEDUCTIBLE | Applies to basic and major services | $25 individual / $75 family |
| BASIC SERVICES | Fillings, simple extractions | 80% |
| MAJOR SERVICES | Oral surgery, root canal, crowns | 50% |
| ORTHODONTIA | Braces for dependent children only to age 19 | 50% to $2,000 Lifetime |
| ANNUAL MAXIMUM | $2,000 per year | |
| DENTAL NETWORK | Delta Dental - Stay in Network to Maximize your Benefits! | |
24/7 access to Virtual Dental Care!
Use Delta Dental Virtual Visits when you:
- have a dental emergency and don’t have a dentist
- need access to a dentist after hours
- need to consult a dentist without leaving home, or while traveling
Call 866-950-4375 or Delta Dental Virtual Dentistry for 24/7 Emergency Virtual Dental Care.
Monthly Premium
| Employee | $10 |
| Employee/Spouse: | $46 |
| Employee/Child(ren): | $46 |
| Family: | $46 |
