Which Traditional Dental Plan is right for you?
Let's help you find the best plan!
Core Plan
$25
.20 per person, per month
per person, per month
Individual
$25.20
Individual + 1
$48.12
Family
$78.90
Deductible (per person/per family per benefit year)
$50/$150
Annual maximum (per person/per family per benefit year)
$1,000
Enhanced Plan
$35
.05 per person, per month
per person, per month
Individual
$35.05
Individual + 1
$67.18
Family
$111.87
Deductible (per person/per family per benefit year)
$50/$1,000
Annual maximum (per person/per family per benefit year)
$1,000
Core Plan - Delta Dental PPO™ /Delta Dental Premier®/Non-Participating Providers
Covered Dental Services³
You Pay
Delta Dental Pays
Waiting Periods
DIAGNOSTIC & PREVENTATIVE SERVICES (No Deductible)
Exams – 2 per benefit year
50%
50%
None
Cleanings – 2 per benefit year
50%
50%
None
Bitewing X-rays – 1 per benefit year
50%
50%
None
Full-mouth/panoramic X-rays – 1 per 60 months
50%
50%
None
Fluoride treatment
50%
50%
None
Space maintainers
50%
50%
None
Sealants
50%
50%
None
BASIC SERVICES (Deductible Applies)
Fillings
50%
50%
6 months
Crown repairs
50%
50%
6 months
Relines and repairs – to bridges and dentures
50%
50%
6 months
Periodontal maintenance – 2 per benefit year; interchangeable with routine cleaning
50%
50%
6 months
MAJOR SERVICES (Deductible Applies)
Gum disease treatment
50%
50%
12 months
Root canals
50%
50%
12 months
Surgical extractions
50%
50%
12 months
General anesthesia
50%
50%
12 months
Crowns – 1 per 60 months
50%
50%
12 months
Complete and partial dentures
50%
50%
12 months
Bridges
50%
50%
12 months
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
Enhanced Plan - Delta Dental PPO™ /Delta Dental Premier®/Non-Participating Providers
Covered Dental Services³
You Pay
Delta Dental Pays
Waiting Periods
DIAGNOSTIC & PREVENTATIVE SERVICES (No Deductible)
Exams – 2 per benefit year
50%
50%
None
Cleanings – 2 per benefit year
50%
50%
None
Bitewing X-rays – 1 per benefit year
50%
50%
None
Full-mouth/panoramic X-rays – 1 per 60 months
50%
50%
None
Fluoride treatment
50%
50%
None
Space maintainers
50%
50%
None
Sealants
50%
50%
None
BASIC SERVICES (No Deductible)
Fillings
50%
50%
6 months
Crown repairs
50%
50%
6 months
Relines and repairs – to bridges and dentures
50%
50%
6 months
Periodontal maintenance – 2 per benefit year; interchangeable with routine cleaning
50%
50%
6 months
MAJOR SERVICES (No Deductible)
Gum disease treatment
50%
50%
12 months
Root canals
50%
50%
12 months
Surgical extractions
50%
50%
12 months
General anesthesia
50%
50%
12 months
Crowns – 1 per 60 months
50%
50%
12 months
Complete and partial dentures
50%
50%
12 months
Bridges
50%
50%
12 months
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | None |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 6 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You Pay | 50% |
Delta Dental Pays | 50% |
Waiting Periods | 12 months |
You will be redirected to our individual plan enrollment website to complete your enrollment. If you have questions, please call (800) 971-4108 to speak to an enrollment specialist.
Which Graduated Dental Plan is right for you?
Let's help you find the best plan!
Coral Plan
$28
.28 per person, per month
per person, per month
Turquoise Plan
$39
.40 per person, per month
per person, per month
Coral Plan - Delta Dental PPO™ /Delta Dental Premier®/Non-Participating Providers
Covered Dental Services
In Year 1, You Pay
In Year 2, You Pay
In Year 3, You Pay
Deductible³
Per person, per family, per benefit year
$50/$150
$50/$150
$50/$150
Annual Maximum Benefits²
Contract Year
$1,000
$1,250
$1,500
Delta Dental networks
Delta Dental PPO™/ Delta Dental Premier®/ Non-Participating Providers
DIAGNOSTIC & PREVENTATIVE SERVICES (No Deductible)
Exams - 2 per benefit year
20%
10%
0%
Cleanings - 2 per benefit year
20%
10%
0%
Bitewing X-rays – 1 per benefit year
20%
10%
0%
Full-mouth/panoramic X-rays – 1 per 60 months
20%
10%
0%
Fluoride Treatment
20%
10%
0%
Space Maintainers
20%
10%
0%
Sealants
20%
10%
0%
BASIC SERVICES (Deductible Applies)
Periodontal Maintenance - 2 per benefit year; interchangeable with routine cleaning
70%
60%
50%
Simple Extractions
70%
60%
50%
Fillings
70%
60%
50%
MAJOR SERVICES (Deductible Applies)
Gum Disease Treatment
70%
60%
50%
Root Canals
70%
60%
50%
Surgical Extractions
70%
60%
50%
General Anesthesia
70%
60%
50%
Denture Relines, Rebases, & Adjustments
70%
60%
50%
Repairs to Crowns, Dentures, & Bridges
70%
60%
50%
Implants
70%
60%
50%
Crowns - 1 per 60 months
70%
60%
50%
Complete & Partial Dentures
70%
60%
50%
Bridges
70%
60%
50%
Per person, per family, per benefit year
In Year 1, You Pay | $50/$150 |
In Year 2, You Pay | $50/$150 |
In Year 3, You Pay | $50/$150 |
Contract Year
In Year 1, You Pay | $1,000 |
In Year 2, You Pay | $1,250 |
In Year 3, You Pay | $1,500 |
In Year 1, You Pay | Delta Dental PPO™/ Delta Dental Premier®/ Non-Participating Providers |
In Year 2, You Pay | |
In Year 3, You Pay |
In Year 1, You Pay | 20% |
In Year 2, You Pay | 10% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 20% |
In Year 2, You Pay | 10% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 20% |
In Year 2, You Pay | 10% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 20% |
In Year 2, You Pay | 10% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 20% |
In Year 2, You Pay | 10% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 20% |
In Year 2, You Pay | 10% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 20% |
In Year 2, You Pay | 10% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
Turquoise Plan - Delta Dental PPO™ /Delta Dental Premier®/Non-Participating Providers
Covered Dental Services³
In Year 1, You Pay
In Year 2, You Pay
In Year 3, You Pay
Deductible
Per person, per family, per benefit year
$50/$150
$50/$150
$50/$150
Annual Maximum Benefits
Contract Year
$1,500
$1,750
$2,000
Delta Dental networks
Delta Dental PPO™/Delta Dental Premier®/Non-Participating Providers
Diagnostic & Preventive Services (NO DEDUCTIBLE)
Exams - 2 per benefit year
0%
0%
0%
Cleanings - 2 per benefit year
0%
0%
0%
Bitewing X-rays – 1 per benefit year
0%
0%
0%
Full-mouth/panoramic X-rays – 1 per 60 months
0%
0%
0%
Fluoride Treatment
0%
0%
0%
Space Maintainers
0%
0%
0%
Sealants
0%
0%
0%
BASIC SERVICES (Deductible Applies)
Periodontal Maintenance - 2 per benefit year; interchangeable with routine cleaning
60%
40%
20%
Simple Extractions
60%
40%
20%
Fillings
60%
40%
20%
MAJOR SERVICES (Deductible Applies)
Gum Disease Treatment
70%
60%
50%
Root Canals
70%
60%
50%
Surgical Extractions
70%
60%
50%
General Anesthesia
70%
60%
50%
Denture Relines, Rebases, & Adjustments
70%
60%
50%
Repairs to Crowns, Dentures, & Bridges
70%
60%
50%
Implants
70%
60%
50%
Crowns - 1 per 60 months
70%
60%
50%
Complete & Partial Dentures
70%
60%
50%
Bridges
70%
60%
50%
Per person, per family, per benefit year
In Year 1, You Pay | $50/$150 |
In Year 2, You Pay | $50/$150 |
In Year 3, You Pay | $50/$150 |
Contract Year
In Year 1, You Pay | $1,500 |
In Year 2, You Pay | $1,750 |
In Year 3, You Pay | $2,000 |
In Year 1, You Pay | Delta Dental PPO™/Delta Dental Premier®/Non-Participating Providers |
In Year 2, You Pay | |
In Year 3, You Pay |
In Year 1, You Pay | 0% |
In Year 2, You Pay | 0% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 0% |
In Year 2, You Pay | 0% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 0% |
In Year 2, You Pay | 0% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 0% |
In Year 2, You Pay | 0% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 0% |
In Year 2, You Pay | 0% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 0% |
In Year 2, You Pay | 0% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 0% |
In Year 2, You Pay | 0% |
In Year 3, You Pay | 0% |
In Year 1, You Pay | 60% |
In Year 2, You Pay | 40% |
In Year 3, You Pay | 20% |
In Year 1, You Pay | 60% |
In Year 2, You Pay | 40% |
In Year 3, You Pay | 20% |
In Year 1, You Pay | 60% |
In Year 2, You Pay | 40% |
In Year 3, You Pay | 20% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
In Year 1, You Pay | 70% |
In Year 2, You Pay | 60% |
In Year 3, You Pay | 50% |
3. For full coverage specifics, including frequencies, limitations and age restrictions, refer to the appropriate plan booklet.
You will be redirected to our individual plan enrollment website to complete your enrollment. If you have questions, please call 800.971.4108 to speak to an enrollment specialist.