Name: Dental for Everyone Gold
Brand: Delta Dental

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$50.46 /mo.

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Dental for Everyone Gold

Plan Type PPO

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$50.46 /mo.

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Plan Highlights

Annual Benefits Increase: Experience the added advantage of annual benefit increases after your first and second years on the plan.
Immediate Coverage: Enjoy immediate coverage for Preventive and Basic services, with a 12-month waiting period only for Major Services.
Extensive Dentist Network: Access exceptional dental care through Delta Dental PPO's extensive national network, comprising over 128,000 dentists practicing in more than 198,000 locations.

Common Procedures

Details

Fee Schedule: N/A | Dentist Search

Exams: Routine periodic examinations – twice in a calendar year
1st Year – 60% after deductible
2nd Year – 80% after deductible
3rd Year and after – 100% after deductible
Preventive – No waiting period

Cleanings: Teeth Cleanings – twice in a calendar year
1st Year – 60% after deductible
2nd Year – 80% after deductible
3rd Year and after – 100% after deductible
Preventive – No waiting period

X-Rays: Radiography: Bitewing and full mouth x-rays
1st Year – 60% after deductible
2nd Year – 80% after deductible
3rd Year and after – 100% after deductible
Preventive – No waiting period

Fillings: Fillings: Restorative Amalgam Fillings. Resin-based composite (white fillings) anterior only
1st Year – 50% after deductible
2nd Year – 65% after deductible
3rd Year and after – 80% after deductible
Basic – No waiting period

Extractions: Extractions and other oral surgery, including pre and post operative care
1st Year – 0% (12 months waiting period)
2nd Year and after– 50% after deductible
Major – 12 months waiting period

Crowns: 1st Year – 0% (12 months waiting period)
2nd Year and after – 50% after deductible
Major – 12 months waiting period

Root Canals: Endodontics: Pulpal therapy and root canals
1st Year – 0% (12 months waiting period)
2nd Year and after – 50% after deductible
Major – 12 months waiting period

Dentures: 1st Year – 0% (12 months waiting period)
2nd Year and after – 50% after deductible
Major – 12 months waiting period

Deep Cleanings: Treatment of diseases of the gums
1st Year – 0% (12 months waiting period)
2nd Year and after – 50% after deductible
Major – 12 months waiting period

Implants: Not Covered Service

Braces / Orthodontia: Not Covered Service

Teeth Whitening: Not Covered Service

Additional Network Information:

Reimbursement is based on Delta Dental PPO Contracted Fees for Delta Dental PPO Providers, PPO Contracted Fees for Delta Dental Premier® Providers and PPO Contracted Fees for Non-Delta Dental Providers. Non-Delta Dental Providers will balance bill the difference. PPO coverage rates are based on Delta Dental’s PPO network. Benefits for In-Network dentists are based on Delta Dental’s reduced PPO fee schedule. PPO dentists will file the claim with Delta Dental. There is no balance billing for PPO dentists.

Exclusions and Limitations
Privacy Policy
Plan Brochure

FAQ

Can I change my dentist once I am in the plan?

Yes, you may change your dentist at any time.

What is a pre-existing condition versus work-in-progress? Is it covered?

What provider options do I have?

When can I start using my Plan?

When will I receive my new member kit and what will it include?

Who can enroll in this plan?

Delta Dental Insurance Company
P. O. Box 1809
Alpharetta, Georgia 30023-1809

Disclaimers & Disclosures

Dental for Everyone Plans are underwritten by Delta Dental Insurance Company. Coverage under the plans is available only to Benefits Association Inc. (BAI) members. If you are not a member of BAI you must join to be eligible for Dental for Everyone Plans. Estimated premium includes the $2.00 per month membership dues for BAI and a monthly billing fee. Coverage under the plans is only available to BAI members in AL, CA, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, TX, UT and WV.

This is a general group summary of the features of the Delta Dental Insurance Company plan issued to Benefits Association, Inc. When you purchase the plan you will receive a Certificate of Coverage that details your rights and obligations, as well as those of the insurance company.

This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.

Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.

This site was designed to provide you with a general description of the plans you requested. Keep in mind that it does not include all the benefits and limitations outlined in the policies -- it is the insurance contract, not the general descriptions on this website, which forms the contract between you and the insurance company.

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