ACA Family Dental Plan - High Option

Dental Benefit Plan Summary

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Good health starts with a healthy smile

A healthy smile is important—not only to your oral health but for your overall health, too. In fact, your dentist can detect more than 120 signs and symptoms of nondental diseases—including cancer, diabetes, heart disease, kidney disease and osteoporosis—during a routine oral exam.*
Having dental coverage helps you get the care you need to stay healthy. It can also help keep your overall health care costs down. That’s why we are pleased to offer you quality individual dental benefits. After all, good health starts with a healthy smile!

Save on the care you need

For example: A dentist may submit a $950 charge for a crown. With dental coverage, the participating dentist accepts a reduced fee of $744. That’s an immediate savings of $206! Furthermore, having Delta Dental coverage means Delta Dental pays a percentage of the already reduced fee. You can see how the advantages of having dental coverage can add up quickly!

The payment example above is for illustration purposes only. Fees and reimbursements can vary by location and dentist. It does, however, represent how the payment is determined.

The dental benefits you need at an affordable price

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    Diagnostic and preventive care - No waiting periods or deductibles.

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    Annual maximum - $1,000 annual maximum per covered person per benefit year.

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    No annual maximum limit on pediatric EHB.

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    Low deductible - See the Summary of Benefits for details. 

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    Deductible only applies to basic and major services.

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    Exceptional customer service- Specialized representatives are available to assist you at (800) 971-4108.

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    Secure online access 24/7 - Delta Dental's secure online Individual Account Manager is a fast, secure way to locate participating dentists, review your claims, access benefit information and more.

Save money by staying in network

Delta Dental provides access to two of the largest dental networks in the nation. You can go to any licensed dentist, but you generally will save money if you go to a dentist who participates in one of our two networks—Delta Dental PPO or Delta Dental Premier. That’s because Delta Dental has established Maximum Approved Fees for nearly all dental services, and participating dentists agree to accept the Maximum Approved Fee as full payment for those services. If the dentist’s fee is higher than Delta Dental’s, he or she cannot charge you the difference. This means you are responsible only for your copayments and deductibles, if any, when you visit a Delta Dental participating dentist.
As an example, say you have met your deductible and visit your dentist for a basic covered service. If the estimated charge of $100 is covered at 80 percent, here’s the out-of-pocket cost based on the participation status of the dentist you choose:

Using your dental benefits

Delta Dental benefits are easy to use. Participating dental offices will complete and file claims for you, so there is no paperwork for you and you don’t have to wait to get reimbursed when visiting participating providers. And if you have any questions, customer service representatives are available to assist you along the way.

Maximize Your Benefits

*Sources: J Am Dent Assoc, Vol 134, No suppl_1, 41S-48S. 2003 American Dental Association and Dental Management of The Medically Compromised Patient, 7th Edition, 2008, Mosby Elsevier, St. Louis, MO.