Dental
Good dental health is an important part of your overall well-being.
Standard and Enhanced Dental PPO Plans Direct Link
Delta Dental administers the Standard and Enhanced Dental PPO Plans through Delta Dental. Both plans give you access to Delta Dental’s network of preferred dentists. If you use a Delta Dental network dentist, your preventive care is covered at 100% and you’ll pay less out-of-pocket costs for other services because network dentists provide services at pre-negotiated rates.
Find Delta Dental network dentists: www1.deltadentalins.com (Click on Find a Dentist)
Call Delta Dental: 800-765-6003
Delta Dental PPO
- (800) 765-6003
- www1.deltadentalins.com
Group #: 21980
DeltaCare HMO Plan Direct Link
The DeltaCare HMO Plan requires you to visit your selected primary care dentist in order to receive benefits. You must choose a dentist for each covered family member. Preventive services are covered at no charge. You pay a fixed copay for other dental services.
Find DeltaCare USA dentists: www1.deltadentalins.com (Click on Find a Dentist)
Call Delta Dental: 800-422-4234
DeltaCare HMO
- (800) 422-4234
- www1.deltadentalins.com
Group #: 79267
Need your Delta Dental Card
Delta Dental cards are mailed out to the home address provided to HR. Digital cards can be accessed through the Delta Dental Mobile App or if you require a hard copy call Delta Dental directly at:
- HMO plans – 800-422-4234
- PPO plans – 800-765-6003
Dental Plan Comparison Direct Link
Benefit Feature | Standard Dental PPO | Enhanced Dental PPO | DeltaCare HMO |
|---|---|---|---|
| 1) $12 copay per tooth for sealants and a $170 copay for space maintainers. 2) $30 copay (child) or $45 copay (adult) for prophylaxis beyond the limit of 2 per year with no copay. 3) Additional charges for evaluation, treatment plan, banding (placement of braces) and retention. | |||
| Plan Year Deductible | $50 per person $150 per family | $50 per person $150 per family | None |
| Plan Year Maximum Benefit | $1,500 | $2,000 | No maximum benefit |
| Diagnostic/Preventive Services | |||
| Preventive Care Oral Exams, X-rays | No charge, no deductible | No charge, no deductible | No charge 1, 2 No charge |
| Basic Services | |||
| Oral Surgery | 20% after deductible | 20% after deductible | $12-$125 copay |
| Restorative (fillings) | 20% after deductible | 20% after deductible | $0-$115 copay |
| Endodontics (root canals) | 20% after deductible | 20% after deductible | Up to $430 copay |
| Major Services | |||
| Crowns | 50% after deductible | 50% after deductible | Up to $500 per unit |
| Dentures | 50% after deductible | 50% after deductible | |
| Orthodontia | |||
| Adolescent benefit (to age 19) | Not covered | 50% after deductible up to $1,500 lifetime max | $1,530-$2,505 copay3 |
| Adult benefit | Not covered | Not covered | $1,730-$2,705 copay3 |
Plan Benefit Premiums Direct Link
Partner benefit rates for the 2023 plan year are available below:
Mainland 2023 partner benefit rates
Hawaii 2023 partner benefit rates
Partner benefit rates for all 2023 plans are available on the benefits enrollment portal.