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 Buy Up

Plan Information

Plan Name: Delta Dental PPO Buy Up  

Policy Number: 21578 

Effective Date: 01/01/2025 

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 (Individual/Family)
$50/up to $150 per family  

Plan Maximum
$2,500 

Preventive Care
$0

Basic Services
20% coinsurance after deductible

Major Procedures
50% coinsurance after deductible

Orthodontia (Adults and Children)
50% up to a Lifetime Maximum of $2,000

Out-of-Network

Deductible (Individual/Family)
$50/up to $150 per family  

Plan Maximum
$2,500 

Preventive Care
$0

Basic Services
20% after deductible 

Major Procedures
50% after deductible 

Orthodontia (Adults and Children)
50% up to a Lifetime Maximum of $2,000

Contact Information

Delta Dental PPO Base 

Plan Information

Plan Name: Delta Dental PPO Base  

Policy Number: 21578 

Effective Date: 01/01/2025

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 (Individual/Family)
$50/up to $150 per family  

Plan Maximum
$1,750 

Preventive Care
$0

Basic Services
20% coinsurance after deductible

Major Procedures
50% coinsurance after deductible

Orthodontia (Adults and Children)
50% up to a Lifetime Maximum of $2,000

Out-of-Network

Deductible (Individual/Family)
$50/up to $150 per family

Plan Maximum
$1,750

Preventive Care
$0

Basic Services
20% coinsurance after deductible

Major Procedures
50% coinsurance after deductible

Orthodontia (Adults and Children)
50% coinsurance up to a Lifetime Maximum of $1,500

Contact Information