Delta Dental PPO™ Individual Basic Plan

Individual plan benefits

Annual maximum: $1,000
Earliest activation TBD
Annual deductible: $50 Individual / $150 Family
No waiting periods for preventive

Join this plan

Delta Dental PPO™ Individual Basic Plan

Individual plan benefits

Annual maximum: $1,000
Earliest activation TBD
Annual deductible: $50 Individual / $150 Family
No waiting periods for preventive

Join this plan

Prices may vary by age and ZIP code.

Delta Dental PPO™ Individual Basic Plan

Dental Dental PPO Individual Basic is a plan that covers a percentage of your costs for covered dental services. Once you enroll, you’ll get coverage for diagnostic and preventive care, including exams, cleanings and x-rays. This plan also covers services like fillings and simple tooth extractions. ***Plus, receive savings on LASIK™ eye surgery through Qualsight™ and hearing benefits through Amplfon™.

Here are some plan benefits.

Preventive care

Cleanings, exams and x-rays are covered at 100% right away

Basic procedures

Basic services are covered at 50% with in-network dentist (after deductible)

Annual maximum benefit

$1,000 annual maximum

Annual deductible

$50 per person; $150 per family

Waiting periods

None for preventive services; 6 months for basic services

Choose any dentist

Visit any licensed dentist, though you’ll generally save more by visiting a dentist from our PPO network

Now let’s see what this plan includes.

*These rates may not apply to you.

**Please consult the plan Policy for a description of plan benefits, limitations and exclusions. In the event of any inconsistency between this document and the plan Policy, the terms of the Policy will prevail.

Delta Dental PPO™ plans are underwritten by Delta Dental Insurance Company in AL, DC (Policy IENT-P-CORE-DC-R22), FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA — Delta Dental of California; PA, MD — Delta Dental of Pennsylvania; NY — Delta Dental of New York, Inc.; DE — Delta Dental of Delaware, Inc.; WV — Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a Dental Provider Organization (DPO) plan.

West Virginia: Learn about our commitment to providing access to a quality dentist network at deltadentalins.com/about/legal/index-enrollee.html.

This benefit information is only a summary and is not intended to replace or serve as the plan Policy.

***Vision corrective services and Amplifon’s hearing health services are not insured benefits. Delta Dental makes the vision corrective services program and hearing health care services program available to provide access to the preferred pricing for LASIK surgery, hearing aids and other hearing services.

Delta Dental is a registered trademark of Delta Dental Plans Association.

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