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Dental

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Delta Dental

Quick Reference

Website

Call Delta Dental's customer service: 888-335-8227

Find a provider

View claims (registration/login required)

Plan group number: Group 1766

 

Coverage Highlights

You choose a Delta Preferred Provider Organization (PPO) dentist, a Delta Premier dentist, or a non-network dentist. Your costs are generally lower when you use a Delta PPO dentist.

Deductible: None

Annual Limit: $2,000 per calendar year per member

Lifetime Maximum (orthodontic): $2,000 per member

Coinsurance (services):

  • Diagnostic/Preventive: Plan pays 75%, you pay* 25%
  • Restorative: Plan pays 75%, you pay* 25%
  • Crowns and Bridges: Plan pays 75%, you pay* 25%
  • Prosthodontics (dentures): Plan pays 75%, you pay* 25%
  • Orthodontics: Plan pays 60%, you pay 40%

* In addition to your coinsurance, you pay any balance due if you visit a non-network dentist.

Liberty Dental

Quick Reference

Website

Call Liberty Dental's customer service: 888-359-1088

Find a provider

View claims (login required)

Plan group number: Group 100323

Coverage Highlights

This is a Dental Health Maintenance Organization (DHMO). You must live in the service area and receive care from participating dental providers.

Deductible (for crowns and bridges only): $75 per calendar year per member

Annual Limit: None

Coinsurance (services):

  • Diagnostic/Preventive: Plan pays 100%, you pay 0%
  • Restorative: Plan pays 100%, you pay 0%
  • Crowns and Bridges: Plan pays 100% (after deductible), you pay $75 deductible
  • Prosthodontics (dentures):* Plan pays 100%, you pay $100
  • Orthodontics:** Plan pays 100%, you pay $1,150

* The Plan pays all but $100 for each upper and lower set of dentures.
** The Plan pays all but $1,150.

Liberty Dental

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