Dental
Taking care of your oral health is not a luxury; it is a necessity for long-term optimal health. With a focus on prevention, early diagnosis, and treatment, Dental insurance can greatly reduce your costs when it comes to restorative and emergency procedures.
When you visit a dentist in the network, you will maximize your savings. These dentists have agreed to reduced fees, which means you won’t get charged more than your expected share of the bill.
Delta Dental PPO Gold
Plan Information
Plan Name: Delta Dental PPO Gold
Policy Number: 16520
Effective Date: 01/01/2025
Provider Network: Delta Dental
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Deductible (Per Individual)
$50/$150
Out-of-Pocket Max (Individual/Family)
$2,000 per member
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50% after deductible up to a lifetime maximum benefit of $2,000 per individual
Out-of-Network
Deductible (Per Individual)
$50/$150
Out-of-Pocket Max (Individual/Family)
$2,000 per member
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50% after deductible up to a lifetime maximum benefit of $2,000 per individual
Plan Documents
Year Carrier Document Name
Contact Information
Delta Dental PPO Silver
Plan Information
Plan Name: Delta Dental PPO Silver
Policy Number: 16520
Effective Date: 01/01/2025
Provider Network: Delta Dental
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
Plan Documents
Year Carrier Document Name
