Dental

Dental

We have dental coverage through Delta Dental of New York. With the Delta Dental of New York PPO plans, you can keep your teeth and gums healthy by getting two free preventive checkups each year. You can also visit a dentist virtually. The Delta Dental network includes providers nationwide who offer services at a reduced cost. Delta Dental screens and selects participating providers, who must meet pre-established certification standards. 

  • Plan Options

    Our dental PPO plans are "passive," so you can go to any dentist you'd like. In-network dentists lower your out-of-pocket costs. Out-of-network dentists give you more choice but cost more.

    Your dental plan options are:

    • Basic PPO Plan — designed for participants who expect to need only basic services

    • Comprehensive PPO Plan — designed for participants who expect to need comprehensive dental coverage

    Key features at a glance:

    • Flexible PPO designs that let you go to any dentist you choose.

    • Affordable coverage that helps you manage the cost of dental treatment.

    • Wide network of providers with negotiated rates that help you save money.

    • In-network cost savings: You pay less when you use a Delta Dental in-network doctor. Estimate your costs in advance with the Delta Dental Online Cost Estimator.

    • Visit a dentist virtually: Connect with a dentist instantly for urgent care, prescriptions, and easier access to dental care. Visit the dentist online with Delta Dental's Virtual Consult.

    For a listing of in-network dentists in your area, call toll-free 1-800-932-0783 or visit Delta Dental. Your group number is 04811.

  • Coverage Details

    This is a snapshot of your dental coverage. Find the full coverage details in the Dental Summary Plan Description in the Documents section on this page. Review your coverage before getting service.

    Services covered under both the Basic PPO Plan and Comprehensive PPO Plan include:

    • Preventive/Diagnostic — including periodic exams, certain x-rays, and cleanings

    • Basic — fillings, root canal therapy for anterior and bicuspids, periodontal treatment, and extractions

    Services only covered under the Comprehensive PPO Plan include:

    • Major — crowns and dentures, molar root canal, osseous surgery, partial and full bone impactions, crown-lengthening, and core build-up

    • Orthodontia — corrective dentistry for children and adults

    Basic PPO Plan

    Comprehensive PPO Plan

    Cleanings per calendar year

    Two

    Two

    Annual deductible for individual/family

    $100 / $300

    $50 / $150

    Annual maximum

    $1,000 per person

    $2,000 per person

    Services — Preventive

    100% covered by plan; not subject to deductible and annual maximum benefit

    100% covered by plan; not subject to deductible and annual maximum benefit

    Services — Basic

    You pay 50% after deductible

    You pay 20% after deductible

    Services — Major

    Not covered

    You pay 50% after deductible*

    Services — Orthodontia (coinsurance / lifetime maximum)

    Not covered

    $2,000 lifetime maximum

    NOTE: *The replacement of, addition to, or modification of existing dentures, crowns, casts, or bridgework is subject to certain conditions and limitations. Contact Delta Dental at 1-800-932-0783 if you need dental work for a pre-existing condition, or visit Delta Dental.

  • Using Your Dental Plan

    Here's how to make the most of your dental benefits:

    • Choose a provider: Selecting a Delta Dental participating dentist gets you the highest benefits from your plan. To find a provider, go to the Delta Dental website and look for “Find a Dentist” in the portal. View login instructions here.

    • Plan ID: Present your plan identification information at your provider's office. The Dental Plan group number is 04811.

    • LifePerks: Support a healthy lifestyle with LifePerks. Access to great discounts and offers just for being a Delta Dental member.

    • Pre-treatment estimates: If your service will exceed $500, request a pre-treatment estimate. This applies to procedures and services your dentist believes will exceed $500 (e.g., crowns, inlays, bridges, periodontics). For more guidance, call Delta Dental at 1-800-932-0783 or visit Delta Dental.

    • Claim status: Review your claim status at Delta Dental to see what you owe, what you've already paid, and what your plan covered, plus how much you have left toward your deductible. Your Explanation of Benefits (EOB) shows all your claims and statements. To file a claim, use the Delta Dental of New York Claim Form.

    • Provider nominations: Nominate your dentist to join the Delta Dental network if you'd like in-network benefits. Visit Delta Dental, select either the Basic PPO or Comprehensive PPO option, and complete the online form. Delta Dental will take it from there.