Delta Dental PPO Plan

Delta Dental PPO Plan

Dental PPO Plan Overview

In-Network & Out-of Network
Individual/Family Deductible (excludes preventive and diagnostic) $50/$150
Annual Plan Maximum Per Person (excludes orthodontia) $2,000
Preventive and Diagnostic 100%
Basic 80% after deductible
Major 50% after deductible
Orthodontia:
Annual Deductible None
Coinsurance 50%
Lifetime Maximum $2,000
Eligibility All members

*Note: Out-of-network reimbursement is provided up to reasonable and customary limits.