Comprehensive Dental Coverage

As low as $59.00
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Comprehensive Dental Coverage

Member Information

Social Security Number (required for insurance products)

Subscription Term = 1 Month

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Spouse Information

First Name Last Name Date of Birth
Gender Social Security Number

Child Information

First Name Last Name Date of Birth
Gender Social Security Number

MONTHLY COMPREHENSIVE DENTAL
Employee Only $59
Employee + Spouse $99
Employee + Child(ren) $96
Family $144
  In-Network Out-of-Network

Preventive & Diagnostic

Exams; Cleanings; Bitewing X-Rays; Full Mouth X-Rays; Fluoride Treat-
ments (Frequency limitations apply); Space Maintainers

 

 

100%

 

 

80%

Basic

Fillings; Simple Extractions; Oral Surgery; Periodontics; Root Canals
(Endodontics); Sealants

 

80%

 

50%

Major

Crowns & Gold Restorations; Bridgework; Full & Partial Dentures; Repair
of Dentures; Implants

 

50%

 

50%

Annual Maximum (per person)

$1,500 $1,500

Annual Deductible

Per Person
Family Maximum
Waived For

 

$50
$150
Preventive & Diagnostic

 

$100
$300
Preventive & Diagnostic

 

Search for an in-network provider: 

  1. Click this link
  2. Select Delta Dental PPO for "your plan"
  3. Select the specialty of your choice
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