Premium Payment Procedures




Dental premiums are due on a monthly basis and may be automatically withdrawn from either a checking or savings account.


Delta Dental Basic Plan Features



  • Diagnostic and preventive care to maintain good oral health.

  • 20% coinsurance after $25 deductible on minor restorative services.

  • Coverage for preventive and minor restorative procedures only.


Delta Dental Basic Summary of Benefits



















Summary of Benefits

Delta Dental Basic

Delta Dental Enhanced

Choosing a dentist

Based on Delta Dental PPO & Premier in-netweork

Based on Delta Dental PPO & Premier in-network

Annual deductible

$25/person; $75/ family

$25/person; $75/family

Annual plan maximum

$1,500

$1,500

Routine oral exams

100%

100%

Preventive: two cleanings/routine office visits per year*

100%

100%

Restorative fillings

80%

80%

Simple extractions

80%

80%

Periodontic services

80%

80%

Crown, bridge and dental implants

Not covered

50%

Endodontics (root canal)

80%

80%

Oral surgery

80%

80%

Complete/partial dentures

Not covered

50%

Orthodontics (up to age 19 on Enhanced plan)

Not covered

50% up to a $1,000 lifetime maximum

Space maintainers

Not covered

Not covered

*Four cleanings for patients with certain medical conditions


Neither crowns, bridges, complete/partial dentures nor orthodontics are covered with Delta Dental Basic.



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



Click here for full plan details.