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Type of Plan |
Plan pays your chosen dentist a monthly fixed rate to provide services as needed. |
Fee-for-service plan. Plan provides reimbursement for services rendered. |
Plan provides maximum benefit when you visit an in-PPO network dentist. |
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Dental Providers |
Must select a dental provider affiliated with the prepaid plan. |
Any licensed dentist. However, out-of-pocket expenses may be lower when visiting a Delta Dental PPO dentist. |
Any licensed dentist, but maximum benefit when visiting a PPO network dentist. If an out-of-PPO network dentist is used, benefits are lower. |
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Orthodontic Providers |
Must use orthodontist affiliated with the prepaid plan. |
May visit any orthodontist. However, out-of-pocket expenses may be lower when visiting a Delta Dental PPO dentist. |
Must visit an in-PPO network orthodontist to receive maximum benefit. |
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Changing Providers |
You may change to another dentist affiliated with the plan, with prior approval. |
May change dentist at any time. |
May change dentist at any time. |
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Deductibles |
No deductible. |
Basic: $50 per person, up to $150 annual maximum per family.
Enhanced: $25 per person, up to $100 annual maximum per family.
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$25 per person, up to $100 annual maximum per family, for PPO network dentists.
$75 per person up to $200 annual maximum per family for non-PPO network dentists.
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Co-payments |
Co-payments for certain covered procedures. May require payment at time of treatment. |
You pay only the co-payment and any deductibles and charges above the annual maximum for covered services when visiting a Delta Dental dentist.
When visiting a non-Delta Dental dentist, you also pay the difference between the dentist’s submitted charges and Delta Dental’s approved fees.
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You pay only the co-payment and any deductibles and charges above the annual maximum for covered services when visiting a Delta Dental dentist.
When visiting a non-Delta Dental dentist, you also pay the difference between the dentist’s submitted charges and Delta Dental’s approved fees.
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Plan Payments |
Plan pays dentist monthly contract fee. |
Payments based on Delta Dentist contracted fees or the maximum plan allowance when non-Delta Dental dentists are used. |
Payments based on Delta Dentist contracted fees or the maximum plan allowance when non-Delta Dental dentists are used. |
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Maximum Benefits per Calendar Year |
No maximum.
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Basic: $2,000 for employee, $1,000 per dependent.
Enhanced: $2,000 for employee and each eligible dependent.
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$2,000 for employee, $2,000 per eligible dependent when PPO network dentists are used.
$1,000 for employee, $1,000 per eligible dependent when non-PPO network dentists are used.
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Implant Benefit |
Premier Access and Western Dental only. |
Not a covered benefit. |
Maximum lifetime benefits of $2,500 for each employee and dependent, if using a PPO plan provider. |
