Dental Plan

This plan focuses on preventive care and maintaining good dental health. Covered services include:

• Semi-annual cleanings and exams
• Basic dental care, including fillings, oral surgery and periodontal services.
• The Healthy Smile, Healthy You program provides one additional cleaning or periodontal maintenance procedure for pregnant members or members with diabetes. Enroll through Delta Dental.
• See the Dental Plan Summary and Basic Dental Plan booklet in the Resources section below for more details.

This plan includes all of the benefits of the basic plan as well as coverage for the following:

• Partial coverage for crowns, dentures, bridges, and other major services.
• Partial coverage for orthodontics for dependent children under age 19.
• See the Dental Plan Summary and Comprehensive Dental Plan Booklet in the Resources section below for more details.
• If you enroll in the comprehensive dental plan, you will have a 12-month waiting period for coverage for orthodontia and major services such as crowns, bridges and dentures. You will still be eligible to receive all other dental benefits, such as routine exams, cleanings, fluoride treatments and fillings during the waiting period.

• Each plan has an annual deductible, which is the amount you must pay upfront before the plan will pay anything for your dental care. The annual deductible for each plan is $25 per person per calendar year or $75 maximum per family. The deductible does not apply to preventive care, such as semi-annual cleanings and exams.
• Each plan has a maximum benefit, which is the total amount of the plan will pay for your dental care in a calendar year. Once the plan has paid this amount for your care, you will be responsible for the total cost of your care for the rest of the year. The maximum benefit for each of our plans is $1,000 per person per calendar year.

• Once you’ve enrolled in either the basic or comprehensive dental plan, you’ll receive an ID card from Delta Dental.
• Find a participating dentist by using Delta Dental’s dentist search tool or call Delta Dental’s Benefit Services at 540-989-8000 or 800-237-6060. The amount that you pay for treatment and services is generally lower when you see a participating dentist.
• Present your Delta Dental ID card to your dental provider at the time of service.
• If your dentist participates with Delta Dental, Delta will pay them directly. You will be responsible for paying any remaining balance.
• If your dentist does not participate, you may be responsible for full payment at the time of service and can then file a claim using the Delta Dental Claim Form below. Delta Dental will send payment to you, based on the amount most commonly charged for the service by participating dentists in the area as determined by Delta Dental. You are responsible for paying any difference between the non-participating dentist's charge and the amount Delta Dental pays to you.
• Register on Delta Dental’s website to track claims, print replacement cards or find a participating dentist.
• Have your dental provider file a pre-treatment review with Delta for any services with an expected cost of $250 or more before you have the service. Delta will review and estimate the amount they will pay and the approximate amount you can expect to pay.

• Delta Dental's Benefits Services: 540-989-8000 or 800-237-6060.

   

• 2026 Basic Dental Plan Summary (PDF)
• 2026 Comprehensive Dental Plan Summary (PDF)
• 2026 Prevention First Flyer (PDF)
• Basic Dental Plan Booklet (PDF)
• Comprehensive Dental Plan Booklet (PDF)
• Delta Dental Claim Form (PDF)
• Delta Dental Dentist Search Tool
• Delta Dental Mobile App (PDF)
• Delta Dental Website
• Virtual Benefit Fair