Join Now: delta-dental-immediate-coverage
Plan Highlights
- Free choice of in-network Dentist
- Benefits up to $3,000 per calendar year
- Ortho lifetime maximum is $1,500
- 12 month waiting period for ortho
- Underwritten by Delta Dental Insurance Company
- Benefits increase after the first and second years
- $25 copay per person per visit / $150 lifetime deductible for Ortho
Benefit Association Disclaimer
One time Non Refundable Processing fee: $35.00
The stated rates above include a four dollar ($4) per month billing fee, a four percent (4%) administration fee, and one dollar ($1) per month fee for membership in the Benefits Association. Membership in the Benefits Association, Inc. is required to enroll in this plan. Should you decide to enroll in this dental plan, you will be prompted during the enrollment process to confirm your acceptance of membership in the Benefits Association. If you are already a member of Benefits Association, please call the member services number located on the back of your membership card, and they will process your enrollment accordingly. Should your effective date fall on, or between, January 1st and June 1st, your policy will renew in January of each year, at which time rates may be subject to change. After your first renewal, the rates will be guaranteed for 12 months each year thereafter. If your effective date is on or between July 1st and December 1st, your policy will renew in July of each year, at which time rates may be subject to change. After your first renewal, the rates will be guaranteed for 12 months each year thereafter.
Benefits
| Description | Plan Pays Year 1 | Plan Pays Year 2 | Plan Pays Year 3 | |
|---|---|---|---|---|
| Diagnostic and Preventative Procedures | Diagnostic: Routine periodic examinations twice in a calendar year. Preventative: Dental prophylaxis (teeth cleaning) twice in a calendar year. Radiography: Bitewing and full mouth x-rays. | 80% | 90% | 100% |
| Basic Procedures | Restorative: Amalgam fillings. Other: Space maintainers, recementation of crowns. | 60% | 70% | 80% |
| Major Procedures | Endodontics: Pulpal therapy and root canals. Periodontics: Treatment of diseases of the gums. Oral Surgery: Extractions and other oral surgery, including pre and post operative care. Prosthetics: Gold restorations, crowns, bridges, partials and complete dentures. Other: Pontics, repair of crowns and bridges, repair of full and partial dentures. | 10% | 40% | 50% |
| Orthodontia Procedures (12 month waiting period) | ($1,500 Lifetime Max, Limited to $300 per Calendar Year) Orthodontic benefits are only available for eligible dependent children. | 0% | 50% | 50% |
| Disclaimer | PPO rates are based on the use of the PPO or Premier network. Payment to PPO Dentist is based on the Delta Dental PPO fee schedule. Payment to the Premier Dentist is based on Delta’s Premier Maximum Contract Allowance. PPO and Premier Dentist will file the claim with Delta Dental. Non Delta Dentist may balance bill up to their fees. |
- Deductible
- $150 lifetime deductible for Ortho
- Office Co-Pay
- $25 Copay Per Person Per Visit
Methods of Payment
- Visa
- Mastercard
- American Express
- Discover
- Bankdraft
Plan Disclosures
Yes. There are some limitations and exclusions with this plan, as with most group insurance policies. For a brief summary of the limitations and exclusions click here.