Keep Your Smile Healthy
Good dental care improves your overall health. The Delta Dental plan is designed to help you maintain a healthy smile through regular preventive dental care and to address any dental problems as soon as they occur. Because preventive care is so important, your dental plan covers these services in full with no deductible or copay.
With the dental plan, you can receive care from any dentist you choose. Your out-of-pocket costs will be less if you choose a Delta Dental PPO network dentist.
Visit www.deltadentaloh.com and click “Find a Dentist” and then “Delta Dental” to find an in-network dentist near you. Look for dentists in the PPO network or Premier Network.
| Delta Dental Rates | Per Pay Single | Per Pay Family |
| $8.50 | $17 |
Call 800-524-0149
or visit www.deltadentaloh.com if you have questions regarding your dental coverage.
Resources
| Plan Features | In-Network | Out-of-Network |
| Deductible (waived for Preventive Services) |
$50 per person $150 family maximum |
|
| Calendar Year Maximum | $1,500 per eligible person per year for all services | |
| Diagnostic and Preventive Services (e.g., X-rays, cleanings, exams) |
100% covered | 90% covered |
| Basic and Restorative Services (e.g., fillings, extraction, root canals) |
20% after deductible | 30% after deductible |
| Major Services (e.g., dentures, crowns, bridges) |
50% after deductible | 60% after deductible |
| Orthodontia (up to age 19) | 50% after deductible $1,000 lifetime maximum per eligible person |
Not covered |
