Dental Plans
Healthy teeth and gums are important to your overall health. That’s why it’s important to have regular dental check-ups and maintain good oral hygiene.
CHOC offers you a choice of dental plans:
- The DeltaCare HMO Plan offers the convenience of scheduled copays for specific procedures and eliminates deductibles or annual maximums. Coverage is only provided for services received in the DeltaCare network of dentists. Find a network dentist HMO
- The Delta Dental PPO Plan offers access to a national network of dentists. You may see any licensed dentist but will save money if you choose a dentist from the Delta Dental network. Find a network dentist PPO
| scroll right on mobile to view -> | DeltaCare HMO | Delta Dental PPO | |
| Copay Amounts | In-Network | Out-of-Network | |
| Annual Deductible | None | $50/$150 | |
| Annual Maximum Benefit | Unlimited | $1,500/person | |
| Preventative Care | Copay Amounts | In-Network | Out-of-Network |
| 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-$70 | 80% | 80% |
| Major Care | Copay Amounts | In-Network | Out-of-Network |
| Crowns (Porcelain/Ceramic) | $95-$195 | 50% | 50% |
| Crowns (Metal) | $95-$155 | 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 | |
Dental Plan Resources
- BrushSmart program overview
- Dental cost estimator
- Dental FAQ
- Virtual teledentistry program
- Virtual consultations
- How to get pre-treatment estimate
- How to manage your plan online
Delta Dental Premier
By seeing a Delta Dental Premier dentist, you will pay a little bit more to see an out-of-network dentist rather than an in-network dentist, but the benefit is you will not be balance billed.
