Dental
Taking care of your oral health is not a luxury; it is a necessity for long-term optimal health. With a focus on prevention, early diagnosis, and treatment, Dental insurance can greatly reduce your costs when it comes to restorative and emergency procedures.
When you visit a dentist in the network, you will maximize your savings. These dentists have agreed to reduced fees, which means you won’t get charged more than your expected share of the bill.
Delta Dental PPO
Plan Information
Plan Name: Delta Dental PPO
Policy Number: 4054
Effective Date: 01/01/2025
Network: Delta Dental
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Deductible (Individual/Family)
$40/$120
Annual Plan Maximum
$2,000
Preventive Care
$0
Basic Services
80% after deductible
Major Procedures
50% after deductible
Orthodontia (Adults and Children)
$2,000
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,800
Preventive Care
$0
Basic Services
80% after deductible
Major Procedures
50% after deductible
Orthodontia (Adults and Children)
$2,000
Plan Documents
Year Carrier Plan Type Document Type
Contact Information
Delta Dental HMO
Plan Information
Plan Name: Delta Dental HMO
Policy Number: 76752
Effective Date: 01/01/2025
Network: Delta Dental
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network Only
Deductible (Individual/Family)
None/None
Annual Plan Maximum
Unlimited
Preventive Care
$0
Basic Services
$0–$300 (See Copayment Fee Schedule)
Major Procedures
$0–$300 (See Copayment Fee Schedule)
Orthodontia (Adults and Children)
$1,500