Name: Dental for Everyone Platinum Premier
Brand: Delta Dental

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$75.42 /mo.

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Dental for Everyone Platinum Premier

Plan Type Indemnity

Dentist Search

$75.42 /mo.

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Plan Highlights

Benefits up to $1500 per calendar year (including ortho benefits)
Benefits increase after the first and second year
Ortho benefits for dependent children included at no extra charge
Keep your dental plan regardless of age
$100 lifetime deductible for ortho
Freedom to choose any dentist
6 month waiting period for basic
12 month waiting period for major and ortho

Common Procedures

Details

Fee Schedule: N/A | Dentist Search

Exams: Routine periodic examinations – twice in a calendar year
1st Year – 80% after deductible
2nd Year – 90% after deductible
3rd Year and after – 100% after deductible
Preventive – No waiting period

Cleanings: Teeth Cleanings – twice in a calendar year
1st Year – 80% after deductible
2nd Year – 90% after deductible
3rd Year and after – 100% after deductible
Preventive – No waiting period

X-Rays: Radiography: Bitewing and full mouth x-rays
1st Year – 80% after deductible
2nd Year – 90% after deductible
3rd Year and after – 100% after deductible
Preventive – No waiting period

Fillings: Restorative Amalgam Fillings. Resin-based composite (white fillings) anterior only
1st Year – 60% after deductible (6 months waiting period)
2nd Year – 70% after deductible
3rd Year and after – 80% after deductible
Basic – 6 months waiting period

Extractions: Extractions and other oral surgery, including pre- and post-operative care
1st Year – 0% (12 months waiting period)
2nd Year – 40% after deductible
3rd Year and after – 50% after deductible
Major – 12 months waiting period

Crowns: 1st Year – 0% (12 months waiting period)
2nd Year – 40% after deductible
3rd Year and after – 50% after deductible
Major – 12 months waiting period

Root Canals: Endodontics: Pulpal therapy and root canals
1st Year – 0% (12 months waiting period)
2nd Year – 40% after deductible
3rd Year and after – 50% after deductible
Major – 12 months waiting period

Dentures: 1st Year – 0% (12 months waiting period)
2nd Year – 40% after deductible
3rd Year and after – 50% after deductible
Major – 12 months waiting period

Deep Cleanings: Treatment of diseases of the gums
1st Year – 0% (12 months waiting period)
2nd Year – 40% after deductible
3rd Year and after – 50% after deductible
Major – 12 months waiting period

Implants: Not Covered Service

Braces / Orthodontia: For eligible dependent children only
1st Year – 0% (12 months waiting period)
2nd Year – 40% after $100 Lifetime Orthodontia Deductible per dependent, up to $350 calendar year maximum and $1000 lifetime maximum
3rd Year and after – 50% after $100 Lifetime Orthodontia Deductible per dependent, up to $350 calendar year maximum and $1000 lifetime maximum
Deductible and Maximums are per eligible dependent child
Major – 12 months waiting period

Teeth Whitening: Not Covered Service

Additional Network Information:

Delta offers Delta Dental Premier Plan (Indemnity Plan) or a Delta Dental PPO plan. The Premier Plan rates are based on Delta Dental’s Premier network. Both Premier and Non-Delta Dental dentists are reimbursed on Usual, Reasonable and Customary (UCR) charges. The Premier dentist will file the claim with Delta Dental and will not balance bill. PPO coverage rates are based on Delta Dental’s PPO network. Benefits for all dentists are based on Delta Dental’s reduced PPO fee schedule. PPO dentists will file the claim with Delta Dental. There is no balance billing for PPO dentists.

Exclusions and Limitations
Privacy Policy
Plan Brochure

FAQ

Can I change my dentist once I am in the plan?

Yes, you may change your dentist at any time.

What is a pre-existing condition versus work-in-progress? Is it covered?

What provider options do I have?

When can I start using my Plan?

When will I receive my new member kit and what will it include?

Who can enroll in this plan?

Delta Dental Insurance Company
P. O. Box 1809
Alpharetta, Georgia 30023-1809

Disclaimers & Disclosures

Dental for Everyone Plans are underwritten by Delta Dental Insurance Company. Coverage under the plans is available only to Benefits Association Inc. (BAI) members. If you are not a member of BAI you must join to be eligible for Dental for Everyone Plans. Estimated premium includes the $1.00 per month membership dues for BAI and a monthly billing fee. Coverage under the plans is only available to BAI members in AL, CA, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, TX, UT and WV.

This is a general group summary of the features of the Delta Dental Insurance Company plan issued to Benefits Association, Inc. When you purchase the plan you will receive a Certificate of Coverage that details your rights and obligations, as well as those of the insurance company.

This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.

Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.

This site was designed to provide you with a general description of the plans you requested. Keep in mind that it does not include all the benefits and limitations outlined in the policies -- it is the insurance contract, not the general descriptions on this website, which forms the contract between you and the insurance company.

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