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Benefits

Retiree - Delta Dental Co-Pay

The Delta Dental Copay Plan is a DHMO product and requires that you choose a dentist from the DeltaCare of Kentucky directory.  There is no coverage out-of-network.  The Copay Plan is only available for the residents of Kentucky.  There are no deductibles or annual plan maximums with this plan.

Click here for full plan details.

Delta Dental Copay Summary of Benefits

 

Delta Dental Copay

Choosing a Dentist

Based on DeltaCare plan network

Annual Deductible
Annual Plan Maximum

None
Unlimited

Covered Benefit:

Routine Office Visit


100%
after $0-$25 copay

Preventive:

Two cleanings/calendar yr.


100%
Restorative Services:
Restorative fillings

See copayment schedule for details.  For info, contact Delta Dental at (800) 955-2030 or visit www.deltadentalky.com to find a provider.

Simple extractions
Periodontic services
Crown or bridge
Endodontics (root canal)
Oral Surgery
Complete/partial dentures
Orthodontics (up to age 19 on Enhanced plan)
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