Benefits

Dental Plans - Delta Dental Copay

At a glance: offers care through the DeltaCare plan network of dentists.  Lowest Delta Dental premium, low out-of-pocket costs. No deductible.  Those covered on the Delta Dental Copay Plan must reside in the state of Kentucky.

The Delta Dental network may be accessed on the web at: www.deltadentalky.com.

Delta Dental Copay Plan Features

  • Diagnostic and preventive care to maintain good oral health.
  • Copayments only.
  • Coverage for preventive, minor and major restorative procedures (after applicable copayment).

Delta Dental Copay Summary of Benefits

 

Delta Dental Copay

Choosing a Dentist

Based on DeltaCare plan Network

You pay…
Annual Deductible
Annual Plan Maximum


None
Unlimited

Covered Benefit:

Routine Office Visit

100% after $0-$25 copay

Preventive:

Two cleanings per calendar year

 

100%

Restorative, Endontic and Orthodontic Coverage:

Restorative filings

Simple Extractions

Periodontic services

Crown or bridge

Endodontics (root canal)

Oral Surgery

Complete/partial dentures

Orthodontics (up to age 19)




See copayment schedule for details.

Copay Plan Schedule