Dental Benefits
Administered by Delta Dental of PA
| Services | Delta Dental High Plan | Delta Dental Low Plan | ||
|---|---|---|---|---|
|
Annual Deductible (Basic & Major Services) |
||||
| Individual | $50 | $75 | ||
| Family | $150 | $225 | ||
| Preventive Services | 100% | 80% | ||
| Basic Services | Plan pays 80% | Plan pays 80% | ||
| Major Services | Plan pays 50% | Plan pays 50% | ||
| Annual Benefit Maximum | $2,000 | $1,500 | ||
|
Orthodontia (child only to age 26) |
50% to a lifetime maximum of $1,000 | 50% to a lifetime maximum of $1,000 | ||
Dental Benefit Summary – High Plan
Dental Benefit Summary – Low Plan
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