With Delta Dental PPO, you get comprehensive dental coverage to keep your smile healthy and your costs manageable. The plan includes free preventive care, such as checkups, cleanings, and X-rays, to catch issues early and help you avoid costly procedures later. The chart below shows the plan’s coverage for in-network, Premier network, and out-of-network services.
With Delta Dental PPO, you can visit any licensed dentist, but you’ll save the most when choosing an in-network provider. Find an in-network provider by visiting www.deltadental.com.
| Plan Features | Delta Dental PPO | ||
|---|---|---|---|
| In-Network | Premier Network | Out-of-Network | |
| Network Name | Delta Dental PPO | Delta Dental Premier | N/A |
| Calendar Year Deductible (waived for Preventive Services) Individual/Family |
$25 / $75 | $25 / $75 | $25 / $75 |
| Dental Annual Maximum | $2,000 per person | $2,000 per person | $2,000 per person |
| Orthodontia Lifetime Maximum | $1,700 per person | $1,700 per person | $1,700 per person |
| You pay: | |||
| Diagnostic & Preventive Services (e.g., x-rays, cleanings, exams) |
0% | 0% | 0% |
| Basic & Restorative Services (e.g., fillings, extractions, root canals) |
10% | 20% | 20% |
| Major Services (e.g., dentures, crowns, bridges) |
40% | 50% | 50% |
| Orthodontia (adults & children) |
50% | 50% | 50% |
It’s easy to take care of your smile with Delta Dental PPO. You’ll enjoy free diagnostic and preventive care, like checkups, cleanings, and X-rays, when you visit an in-network dentist.
To find one near you, visit http://www.deltadental.com/us/en/member/find-a-dentist.html.
With Delta Dental PPO, the cost of coverage depends on who you choose to include. Whether you’re covering just yourself, yourself and a spouse, children, or the whole family, your rates will vary—but everyone gets access to the same great benefits—including orthodontia!
| Employee Cost | Bi-weekly |
|---|---|
| Employee Only | $5.03 |
| Employee + Spouse | $11.05 |
| Employee + Children | $10.05 |
| Employee + Family | $15.07 |
| Employee Cost | Weekly |
|---|---|
| Employee Only | $2.61 |
| Employee + Spouse | $5.74 |
| Employee + Children | $5.22 |
| Employee + Family | $7.82 |