Dental

Great oral health is an essential part of a healthy lifestyle. Through Delta Dental, we offer two dental plans that cover routine checkups and other dental care: Delta Dental Silver and Delta Dental Gold. The plans differ in how much you pay per pay period and how much you pay at the time of service.

Covered services

Both dental plans provide benefits for:

  • Preventive services, such as oral exams, cleanings and x-rays
  • Basic services, such as fillings, extractions, root canal therapy and treatment of gum disease
  • Major services, such as crowns, bridges and dentures

The Gold plan also covers orthodontic services for all enrollees with a lifetime maximum benefit of $1,500.

 

Silver

Delta Dental PPO or Premier Dentist—You Pay

Gold

Delta Dental PPO or Premier Dentist—You Pay

Annual Deductible*
Employee $50 $50
Family $150 $150
Annual Maximum Payment**
Per Person, Per Calendar Year $1,000 $1,500
Covered Services
Diagnostic & Preventive Services
Exams, Cleanings, Fluoride, Sealants, X-rays
0% 0%
Basic Services
Emergency Palliative Treatment, Minor Restorative Services, Periodontics, Endodontic
20% 10%
Major Services
Crowns, Bridges, Implants, Dentures
50% 40%
Orthodontics (no age limit) Not covered 50%
Orthodontic Lifetime Benefit N/A $1,500

*$50 deductible per person total per calendar year limited to a maximum deductible of $150 per family per calendar year on all services except diagnostic and preventive services.
**Per person total per calendar year on diagnostic and preventive, basic services, and major services. Non-participating dentists are paid at the 90th percentile.

Benefit tip! You can also use your Health Care Flexible Spending Account—or, if you're enrolled in the High Deductible Health Plan, your Health Savings Account (HSA) or Limited-Purpose Flexible Spending Account—to pay for eligible dental expenses (that are not covered by another plan) on a pre-tax basis. Keep in mind that cosmetic procedures, such as teeth whitening, are not considered eligible expenses.

Locating a Delta Dental dentist

To locate a participating dentist in your area, call 800-223-3104 or visit www.deltadentaltn.com

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