Dental Benefits Overview
Dental Provider Network
Delta Dental is the Health Plan’s dental provider network.
For a list of network dentists in your area, go to deltadentalins.com
or call (800) 427-3237.
For Delta Dental coverage cards, call (800) 765-6003.
For DeltaCare coverage cards, call (800) 422-4234.
Click here for a summary of your Delta Dental PPO benefits.
Below is a summarized schedule of dental benefits under the Health Plan.
| Network Dentists | Non-Network Dentists | |
|---|---|---|
| Calendar Year Maximum | $2,500 per person; Does not apply to children under age 19. | |
| Calendar Year Deductible | $0 | $50/person; $100/family |
| Co-Insurance (Category I) | 100% of covered expenses | 85% of covered expenses |
| Co-Insurance (Category II) | 80% of covered expenses | 60% of covered expenses |
| Co-Insurance (Category III) | 70% of covered expenses | 50% of covered expenses |
| Orthodontia | No deductible; 50% of covered expenses; Coverage only available for dependent children under age 19; Lifetime maximum payment of $1,500 per dependent child. |
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