Dental
You have two dental plan options available to you and your family.
The following chart outlines the dental benefits available through Delta Dental of Missouri. You have two national networks to choose from: PPO and Premier. When visiting a Delta Dental PPO dentist, you receive the highest benefit levels, and your out-of-pocket costs are likely to be lower. Below are the costs for what you pay for each plan.
Need Help Finding a Dentist?
To see if your dentist is in the Delta Dental PPO Network or the Delta Dental Premier Network or to search for a new dentist, visit www.deltadentalmo.com or call 800-392-1167.
Dental Basic Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$1,000
Preventive Care
$0
Basic Services
Delta Dental PPO Dentist: 10%
Delta Dental Premier Dentist: 20%
Major Procedures
Delta Dental PPO Dentist: 40%
Delta Dental Premier Dentist: 50%
Orthodontia (Adults and Children)
Not covered
Out-of-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$1,000
Preventive Care
$0
Basic Services
20%
Major Procedures
50%
Orthodontia (Adults and Children)
Not covered
Benefits Eligible Employee Bi-Weekly Plan Cost
Employee Only: $0
Employee and Spouse/DP: $18.97
Employee and Child(ren): $18.66
Employee and Family: $35.67
Advisor Monthly Plan Cost
Employee Only: $0
Employee and Spouse/DP: $41.11
Employee and Child(ren): $40.43
Employee and Family: $77.29
Dental Plus Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
Delta Dental PPO Dentist: $25/$75
Delta Dental Premier Dentist: $50/$150
Plan Maximum
$1,500
Preventive Care
$0
Basic Services
Delta Dental PPO Dentist: 10%
Delta Dental Premier Dentist: 20%
Major Procedures
Delta Dental PPO Dentist: 40%
Delta Dental Premier Dentist: 50%
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,500 per individual
Out-of-Network
Deductible (Individual/Family)
$50/$150
Plan Maximum
$1,500
Preventive Care
$0
Basic Services
20%
Major Procedures
50%
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,500 per individual
Benefits Eligible Employee Bi-Weekly Plan Cost
Employee Only: $4.29
Employee and Spouse/DP: $27.64
Employee and Child(ren): $40.86
Employee and Family: $62.35
Advisor Monthly Plan Cost
Advisor Only: $9.29
Advisor and Spouse/DP: $59.88
Advisor and Child(ren): $88.52
Advisor and Family: $135.10