Dental Plan
We partner with Delta Dental to offer you and your family members dental insurance. Access to good oral healthcare can help keep your overall health costs down. Regular oral health exams can help detect significant medical conditions before they become serious. Visit deltadentalmo.com to find in-network providers and access a variety of online tools and programs.
Although the Delta Dental plan allows you the freedom to visit any licensed dentist, you’ll save the most when you visit a Delta Dental PPO dentist. A Delta Dental Premier dentist is your next best option when you can’t find a PPO dentist.
Important Notes
- Dental and vision coverage is bundled together. You cannot select one without the other.
- You may enroll in or make changes to your dental benefits every two years unless you have a Qualified Life Event (QLE).
Plan Details
| Delta Dental PPO Network | Delta Dental Premier Network | Out-Of-Network | |
|---|---|---|---|
| Calendar Year Deductible | |||
| Individual | $0 | $0 | $25 |
| Family | $0 | $0 | $75 |
| Annual Maximum Benefit | |||
| $1,500 | $1,500 | $1,500 | |
| Dental Care Services | |||
| Preventive Care | 100% covered | 100% covered | 80% covered, no deductible |
| Basic Care | 20% coinsurance | 20% coinsurance | Deductible then 20% coinsurance |
| Major Care | 50% coinsurance | 50% coinsurance | Deductible then 50% coinsurance |
| Orthodontia | |||
| Coinsurance | 50% covered no deductible | ||
| Lifetime Maximum | $1,000 | ||
| Benefit Applies To | Adults and children | ||
This is a summary of coverage. Full coverage details are available in your Summary Plan Description (SPD) or official Plan Documents. In the event there are differences between this summary and your official Plan Documents, your Plan Documents prevail.
Orthodontia Services Note
The lifetime maximum illustrated is different from the calendar year maximum. For orthodontia services, this limit does not reset each year, this is the most your plan will cover for your services for the lifetime of your participation in this program.
Examples of Services
- Preventive—exams, cleanings, fluoride, x-rays and sealants
- Basic—fillings, extractions, periodontics, repairs and oral surgery
- Major—crowns, inlays, dentures and dental implants
Keep Smiling!
Delta Dental is our dental plan provider.
Find in-network providers and access online tools and programs.
Visit: deltadentalmo.com
- Call: 800.335.8266
Additional Information
Dental Care Cost Estimator
How to Find a PPO Dentist
Pre-Treatment Estimates
Delta Dental App
