The following compares retiree costs for certain types of procedures under each dental plan. Please consult each dental plan's evidence of coverage for detailed information and plan limitations.
Coverage and Costs for Certain Procedures
Type of Plan | DeltaCare USA, Premier Access, and Western Dental (Standard) |
MetLife* (Enhanced) |
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Who is Covered? | Retirees and Dependents | Retirees and Dependents |
Diagnostic and Preventive Benefits (two cleanings annually) | No charge | No charge* |
Basic Benefits | No charge | No charge |
Crowns | $50 | No charge |
Bridges, Full and Partial Dentures | $65 and up | No charge |
Implants |
Premier Access and Western Dental only | Not covered |
Orthodontia | $1,000, plus up to $250 for start-up costs | $1,000, plus up to $250 for start-up costs |
*Benefits provided by SafeGuard Health Plans, Inc. a MetLife company. SafeGuard provides the availability for a third cleaning to the retiree and all enrolled dependents.