Dental
Delta Dental DPO (Dental Provider Organization) offers comprehensive coverage nationwide. Under Delta’s DPO plans, you and your eligible dependents can receive additional savings by utilizing a Delta Dental contracted dentist. To locate a contracted dentist, download Delta’s mobile app or visit www.DeltaDentalins.com and select “PPO Network, or call 800-521-2651.
DPO Low Plan
This plan covers preventive, basic and major services.
| Category | Semi-monthly Premium |
|---|---|
| Employee | $11.67 |
| Employee + Spouse/Domestic Partner | $23.24 |
| Employee + Child(ren) | $28.46 |
| Employee + Family | $37.73 |
DPO High Plan
This plan covers preventive, basic and major services. It also covers adult and child(ren) orthodontics and implants.
| Category | Semi-monthly Premium |
|---|---|
| Employee | $12.82 |
| Employee + Spouse/Domestic Partner | $25.61 |
| Employee + Child(ren) | $34.86 |
| Employee + Family | $45.30 |
Delta’s DPO Benefit Summaries [PDF]
Delta’s DPO Orthodontics Takeover Form [PDF]
DeltaCare USA DHMO (Dental Health Maintenance Organization) Plan 13B requires you and your covered family members to select a general dentist from the DeltaCare USA provider network. Your selected primary dentist will refer you to a specialist (Pediatric, Orthodontist) for extended services if needed. To locate a contracted dentist, download the app or visit www.deltadentalins.com and select the “DeltaCare USA” network or call 800-422-4234. This plan does not cover Implants or temporomandibular.
| Category | Semi-monthly Premium |
|---|---|
| Employee | $6.50 |
| Employee + Spouse/Domestic Partner | $10.45 |
| Employee + Child(ren) | $14.47 |
| Employee + Family | $16.45 |
Delta’s DHMO Benefits Summary [PDF]
Delta’s DHMO Orthodontics Takeover Form [PDF]
Delta’s Mobile App Brochure [PDF]
Delta’s DPO & DHMO Plan Comparison [PDF]
Delta’s DPO & DHMO Amplifon and Laski Discount Brochure [PDF]