Dental

Overview

CHOC offers a choice of dental plans with different benefit levels and costs, so you can choose the one that works best for you.

The DeltaCare HMO offers the convenience of scheduled copays for specific procedures and eliminates deductibles or annual plan maximums. However, coverage is provided only for services received in the DeltaCare network
The Delta Dental PPO offers access to a national network of dentists. You may see any provider you choose, but you will save money if you receive services from a dentist in the Delta Dental PPO network
If you enroll in the Delta Dental PPO, you will also have access to the Delta Dental Premier network. If you see a provider outside the Delta Dental PPO network but in the Premier network, you may pay a little more, but you will not be billed for costs exceeding the Delta Dental contracted fees

You can enroll in dental coverage as a new hire, newly eligible for coverage, during Open Enrollment, or if you have a qualifying life event.

Our dental coverage provides:

Free in-network preventive and diagnostic care

to help keep your teeth healthy.

Affordable coverage

that helps you manage the cost of dental treatment.

Wide network of providers

that have agreed to negotiated rates, which helps you save money.

Plan Comparison

Coverage details

Preventive Care	Copay Amounts	In-Network	Out-of-Network
	DeltaCare HMO	Delta Dental PPO
	Copay Amounts	In-Network	Out-of-Network
Annual Deductible	None	$50/$150
Annual Maximum Benefit	Unlimited	$1,500/person
Exams	No Charge	100%	100%
Cleaning	No Charge	100%	100%
Full Mouth X-rays	No Charge	100%	100%
Basic Care	Copay Amounts	In-Network	Out-of-Network
Amalgam Fillings	No Charge	80%	80%
Endodontics
Anterior Root Canal	$45	80%	80%
Bicuspid Root Canal	$90	80%	80%
Molar Root Canal	$205	80%	80%
Periodontics
Gingivectomy per Quadrant	$50-$80	80%	80%
Oral Surgery
Simple Extraction	$15	80%	80%
Impaction	$25-$90	80%	80%
Major Care	Copay Amounts	In-Network	Out-of-Network
Crowns (Porcelain/Ceramic)	$95-$195	50%	50%
Crowns (Metal)	$95-$195	50%	50%
Bridges	$55-$195	50%	50%
Dentures	$100-$170	50%	50%
Orthodontics	Copay Amounts	In-Network	Out-of-Network
Child	$1,700	50%
Adult	$1,900	Not Covered
Lifetime Maximum	N/A	$1,500

You pay for dental coverage through pre-tax premiums from your paycheck. The amount you pay will depend on which plan you choose and whether you cover just yourself or family members, too. You can view your plan costs on the Workday website.

Under the Delta Dental PPO, you can see any dentist you want, but you’ll generally pay less by staying in network. Selecting a dentist in the Delta Dental network will ensure you receive your plan’s highest benefits. Visit the Delta Dental website to find an in-network dentist near you.

Request an estimate for procedures and services your dentist believes will exceed $300 (procedures such as crowns, inlays, bridges, and periodontics). For more information, call Delta Dental at 888-335-8227 if enrolled in the PPO plan, or 800-422-4234 if enrolled in the HMO plan, or visit the Delta Dental website.

Use your Health Savings Account (HSA), Limited Purpose Flexible Spending Account (FSA), or Health Care FSA to pay for eligible dental expenses with tax-free dollars.

Visit the Delta Dental website to find a dentist, review claims, check coverage details, and more.

HMO Plan

The DeltaCare HMO offers the convenience of scheduled copays for specific procedures and eliminates deductibles or annual plan maximums. However, coverage is provided only for services received in the DeltaCare network.

PPO Plan

The Delta Dental PPO offers access to a national network of dentists. You may see any provider you choose, but you will save money if you receive services from a dentist in the Delta Dental PPO network.

If you enroll in the Delta Dental PPO plan, you will also have access to the Delta Dental Premier network. If you see a provider outside the Delta Dental PPO network but in the Premier network, you may pay a little more, but you will not be billed for any costs exceeding Delta Dental contracted fees. Learn more about the difference between the Delta Dental PPO network and Delta Dental Premier network here.

Click here to learn how and why to choose a Delta Dental PPO or Delta Dental Premier dentist.

Find a Dentist

To find an in-network provider, visit Delta Dental. Enter your address, city, or ZIP code, and select your plan’s network. Be sure to select the correct network from the drop-down list so you can find the right provider:

If you enroll in the DeltaCare HMO plan, select the DeltaCare network. Coverage is provided only if you see an in-network provider
If you enroll in the Delta Dental PPO, you can select the Delta Dental PPO network, which provides access to a national network of dentists. You may choose to see an out-of-network provider, but you will save money if you see a provider in the Delta Dental PPO network
With the Delta Dental PPO, you also have access to Delta Dental Premier providers. You will pay a little more to see a dentist in this network, but you will not be billed for any costs exceeding Delta Dental contracted fees

Tools & Resources

Your dental plan offers additional features to help you get the most from your coverage.