How do I find a dentist?What services are covered?Can my kids get braces?
Network Options: High Plan or Low Plan on the Delta Dental PPO Network
Whether you need routine cleanings, braces, or a filling, a solid dental plan makes it easier for you to help protect your smile and your budget. When choosing your dental plan, you want to consider the following:
- Routine visits to the dentist help prevent costly dental bills later on, as well as problems linked to medical conditions like diabetes or heart disease.
- If you have a choice of plans, consider your oral health needs and ability to pay for unexpected major services, like a crown.
- If you have children, consider more comprehensive coverage for less out-of-pocket costs and an option for braces.
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Dental Plans |
Delta Dental Low Plan
With this you will only have access to the Delta Dental PPO Network and you must work at least 20 hours each week to be eligible.
Out-of-network coverage
A dentist who is “out-of-network” means the provider hasn’t agreed to negotiated rates. The plan pays benefits based on the reasonable & customary charge for a particular service. If the out-of-network provider charges more, you’ll be responsible for paying the amount that exceeds the reasonable & customary limit plus the applicable coinsurance and deductible.
| Delta Dental PPO – Low Plan | ||
|---|---|---|
| In-Network | Out-of-Network* | |
| Annual Deductible Jan 1 – Dec 31 |
You pay up to $50 per individual $150 per family |
You pay up to $50 per individual $150 per family |
| Annual Maximum Jan 1 – Dec 31 |
$1,000 per individual | $1,000 per individual |
| Waiting Period | 30 days for Preventive, Basic, Major, and Orthodontic Services | |
| Preventive Services Exams, X-Rays, Prophylaxis, Fluoride, Sealants |
Plan pays 100% of covered services, No deductible |
Plan pays 80% AD |
| Basic Services Space Maintainers, Minor Restorative, Extractions, Surgical Extractions, Other Oral Surgery, Palliative Treatment, Consultation |
You pay 20% AD | You pay 40% AD |
| Major Services Stainless Steel Crowns, Endodontics, Periodontics Surgical, Periodontics Non-Surgical, Periodontal Maintenance, Denture Repair/Reline/Rebase, IV Sedation & Anesthesia, Major Restorative, Prosthodontics Removable, Prosthodontics Fixed, Implants Surgical, Implants Non-Surgical |
You pay 50% AD | You pay 60% AD |
| Orthodontic Services | Not Covered | Not Covered |
AD: After Deductible
Delta Dental High Plan
With this you will only have access to the Delta Dental PPO Network and you must work at least 20 hours each week to be eligible.
Out-of-network coverage
A dentist who is “out-of-network” means the provider hasn’t agreed to negotiated rates. The plan pays benefits based on the reasonable & customary charge for a particular service. If the out-of-network provider charges more, you’ll be responsible for paying the amount that exceeds the reasonable & customary limit plus the applicable coinsurance and deductible.
| Delta Dental PPO – High Plan | ||
|---|---|---|
| In-Network | Out-of-Network* | |
| Annual Deductible Jan 1 – Dec 31 |
You pay up to $50 per individual $150 per family |
You pay up to $50 per individual $150 per family |
| Annual Maximum Jan 1 – Dec 31 |
$1,750 per individual | $1,750 per individual |
| Waiting Period | 30 days for Preventive, Basic, Major, and Orthodontic Services | |
| Preventive Services Exams, X-Rays, Prophylaxis, Fluoride, Sealants |
Plan pays 100% of covered services, No deductible |
Plan pays 80% AD |
| Basic Services Space Maintainers, Minor Restorative, Extractions, Surgical Extractions, Other Oral Surgery, Palliative Treatment, Consultation |
You pay 20% AD | You pay 30% AD |
| Major Services Stainless Steel Crowns, Endodontics, Periodontics Surgical, Periodontics Non-Surgical, Periodontal Maintenance, Denture Repair/Reline/Rebase, IV Sedation & Anesthesia, Major Restorative, Prosthodontics Removable, Prosthodontics Fixed, Implants Surgical, Implants Non-Surgical |
You pay 50% AD | You pay 50% AD |
| Orthodontic Services Lifetime Maximum Dependent Children |
$1,500 per individual Plan pays up to 50% |
$1,500 per individual Plan pays up to 50% |
AD: After Deductible
This information is designed to help you choose a benefit plan for 2026 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
