Four Plan Options
Find the one that’s right for you!
You can review availalble plans below. When you're ready to enroll, visit our enrollment site here:
All of our plans include Right Start 4 Kids (RS4K), where kids 12 and under receive coverage at 100% for all services covered under the plan when an in-network dentist is seen. Learn more by choosing a plan below.
Select how many people will be covered under your dental plan
Platinum Plan
individual coverage
per month
| Annual Maximum | $2,500 |
|---|---|
| Preventative (exams, cleanings) | 100% |
| Basic (fillings, non-surgical extractions) | 80% |
| Major (root canals, crowns, gum disease treatment) | 70% |
| Implants | 70% |
Gold Plan
individual coverage
per month
| Annual Maximum | $1,500 |
|---|---|
| Preventative (exams, cleanings) | 100% |
| Basic (fillings, non-surgical extractions) | 80% |
| Major (root canals, crowns, gum disease treatment) | 50% |
| Implants | N/A |
Silver Plan
individual coverage
per month
| Annual Maximum | $1,000 |
|---|---|
| Preventative (exams, cleanings) | 100% |
| Basic (fillings, non-surgical extractions) | 50% |
| Major (root canals, crowns, gum disease treatment) | 50% |
| Implants | N/A |
Bronze Plan
individual coverage
per month
| Annual Maximum | $1,000 |
|---|---|
| Preventative (exams, cleanings) | 100% |
| Basic (fillings, non-surgical extractions) | 80% |
| Major (root canals, crowns, gum disease treatment) | N/A |
| Implants | N/A |
| Delta Dental PPO Dentist | Delta Dental Premier Dentist | Out-of-Network Dentist | |
|---|---|---|---|
Deductible per person, per contract year; Deductible does not apply to Diagnostic & Preventative Services. |
$50 | $50 | $50 |
| Benefit Categories | Coinsurance paid by Delta Dental | ||
Right Start 4 KidsSM (RS4K) - Applies to Kids 12 & Under Kids 12 and under receive coverage at 100% for all services covered under the plan. Must see an in-network dentist or the plan's underlying contract applies including waiting periods, deductibles and coinsurance levels. No waiting period, no deductible Subject to plan's Annual Maximum, frequencies and limitations apply |
100% | 100% | RS4K does not apply |
Diagnostic & Preventative Services check-ups, teeth cleanings, x-rays, sealants, fluoride, space maintainers No waiting period, no deductible |
100% | 80% | 80% |
Basic Services fillings, non-surgical extractions 6 month waiting period |
80% | 70% | 70% |
Major Services dentures, root canals, gum disease treatment, crowns, bridges, surgical tooth extractions 12 month waiting period |
70% | 50% | 50% |
Implants artificial teeth secured to the jaw, certain limitations may apply 12 month waiting period |
70% | 50% | 50% |
Night Guards tooth grinding & jaw clenching prevention 12 month waiting period |
70% | 50% | 50% |
Certain services listed above have frequencies and limitations.
Exclusions and Limitations. For a complete list of exclusions and limitations, refer to your contract. Common non-covered services (exclusions) include the following: services which are available from any Federal or State government agency, or similar entity; services for injuries compensable under an automobile policy or worker’s compensation or similar employer coverage; cosmetic services (unless stated otherwise); services started prior to coverage; services that are not completed; administrative fees such as missed appointments; temporary services and procedures; duplicate dentures; prescription drugs, premedications and relative analgesia, including hospital, healthcare facility or medical emergency room charges; laboratory charges; anesthesia for restorative dentistry; preventive control programs; injuries or disease intentionally self-inflicted or occurring during or as a result of participation in riots or civil disobedience of any form, acts of war, or criminal activity; appliances or restorations to restore occlusion, splinting, equilibration, or replace tooth structure lost by attrition; restorations in conjunction with overdenture; services provided outside of the United States or Canada; dental implants (except for the Platinum plan); services related to TMJ; and services, supplies or treatments not specifically listed as covered in the member’s contract. Common limitations include: the least costly professionally accepted treatment to achieve reasonable functionality; costs of procedures necessary to prevent or eliminate oral disease and for appliances or restorations to replace missing teeth as allowed by the plan; frequency and combined service limitations related to restorations, individual crowns, prosthetic appliances, and periodontal procedures as identified within the contract; and other frequency, age or contractual limitations as specified. Additionally, for implant procedures, benefits are allowed for a bilateral partial if teeth are missing in both quadrants of the same arch. See Benefit Booklet for additional details on exclusions and limitations.
Don't live in Kansas? Visit our national website if you're looking for individual dental insurance in another state.
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