Maintaining good oral health is extremely important to protecting your overall health. You only get one set of teeth and gums — wouldn’t you rather keep them healthy and strong?
Delta Dental PPO + Premier
|Annual Deductible||$50 Individual/$150 Family|
|Annual Maximum per Person||$1,500|
|Preventive and Diagnostic Care||100% covered and not subject to the deductible or the annual maximum|
|Fillings||80% covered after the deductible|
|Crowns||80% covered after deductible is met; limited to one replacement crown every five years|
|Orthodontia Coverage||60% covered, limited to $2,000 per child or adult, per lifetime|
2019 Annual Dental Paycheck Costs
Save with In-Network Providers
While you can go to any dentist to receive care, to get the highest level of coverage, reduce your out-of-pocket costs, and make the claim filing process easier, you’ll want to use a dentist that is in the Delta Dental PPO network. If you can't find a dentist in the PPO network, the next best option is the Delta Dental Premier network.
To learn whether your dentist is in the Delta Dental PPO Network, visit deltadentalins.com/kimberly-clark and select the “Find a Dentist” box on the home page to search for in-network providers. Then select the Delta Dental PPO Network in the search results to maximize your savings.
How You Pay For Care
When you visit network providers, they will automatically submit a claim on your behalf. After the claim is submitted, you'll receive what's called an Explanation of Benefits (EOB) from Delta Dental. Review your EOB carefully and contact Delta Dental if anything looks inaccurate. If it's correct, you pay your dentist your share of the costs not covered by the dental plan.
Preventive and Diagnostic Care
If you enroll in Individual coverage, you need to meet a $50 deductible before non-preventive services are covered.
If you enroll in 2-Party or 2-Party Plus coverage under the Dental plan, a family member must meet the individual deductible before the plan will pay for their care. But, once any combination of your family reaches a total of $150, the plan begins to pay benefits for the entire family.
Keeping those pearly whites pearly and white is an important part of the Plan. Preventive checkups are covered at 100%, twice a year, and are not subject to the deductible or annual maximum.
Some services, such as crowns and fillings, are subject to coinsurance — meaning that you will pay a portion of the cost of service even after your deductible is met. You may also be limited in the number of times you can receive the same covered service over time (e.g., crowns, which are limited to one replacement every five years).
The PPO + Premier plan pays an annual maximum of $1,500 per covered person. This is the most the plan will pay for any one person’s covered services, per year, excluding preventive. There’s an exception for orthodontic services, which have a lifetime benefit maximum of $2,000.
You’ll receive an ID card when you first enroll. While you may not always be asked to present it when you receive care, keep it handy to make sure the correct coverages and discounts are applied. You can also request an extra ID card through Delta Dental Customer Service.