Dental Benefits
Your dental plan allows for three free cleanings each year. You’re welcome to visit any practitioner you’d like but staying in the PPO and Premier networks will provide you with the highest level of benefits. For example, non-network providers are allowed to balance bill you for any amount they deem as “Reasonable and Customary”.
2021 Dental Benefits
Visit deltadentalaz.com or call (800) 532-6132 to find an in-network dentist near you. Remember to use your Group Number: 04409 when making an appointment.
Covered Services
Delta Dental
Annual Deductible (Individual/Family)
$50/$150
Annual Maximum Benefit
$1,500
Lifetime Orthodontia Maximum
$2,000
Preventive Services: exams, evaluations, x-rays, routine cleanings, topical fluoride, space maintainers
100%
Basic Services: sealants, fillings, stainless steel crowns, endodontics, periodontics, oral surgery simple and surgical extractions
80%
Major Services: prosthodontics, bridge and denture repair, implants, restorative
50%
Orthodontic Services
(adults and children over 8)
50%
Contact Us
If you have questions, contact Delta Dental at (800) 532-6132.