No one has a smile like you. And no one can keep it healthy like us.
$56
.00 Per Month / Single
Per Month / Single
Including our best preventive care features to keep you healthy!
Diagnostic & Preventive Services
100%
Other Services
50%
Orthodontics
No
One-time Deductible
$50 per person
Annual Maximum
$1,200
Health through Oral Wellness
Yes
Prevention Pays
Yes
Individual & Family Plan (2023)
Traditional Plan [1040]
Network: PPO Plus Premier
Traditional Plan
Monthly Rate: Single
$56.00
Monthly Rate: Couple/Two Person
$112.00
Monthly Rate: Family
$165.80
Diagnostic & Preventive Services
Routine exams, cleanings, x-rays and more!
100%
Fillings
Cavity repair
50%
Extractions & Oral Surgery
Including wisdom teeth
50%
Endodontics & Periodontics
Root canals, gum disease treatment, periodontal maintenance cleanings - 1 year wait for coverage
50%
Major Restorative Services
Crowns, bridges, dentures, implants - 1 year wait for coverage
50%
Orthodontics
Braces
None
Health through Oral Wellness
Added benefits if you're at high risk of tooth decay or gum disease
Yes
Prevention Pays
Covers diagnostic and preventive care beyond annual maximum benefit
Yes
Deductible
One time per person
$50
Annual Maximum Benefit
Per person per calendar year
$1,200
Dependents
Covered to age 19 or full-time unmarried student
Traditional Plan | $56.00 |
Traditional Plan | $112.00 |
Traditional Plan | $165.80 |
Routine exams, cleanings, x-rays and more!
Traditional Plan | 100% |
Cavity repair
Traditional Plan | 50% |
Including wisdom teeth
Traditional Plan | 50% |
Root canals, gum disease treatment, periodontal maintenance cleanings - 1 year wait for coverage
Traditional Plan | 50% |
Crowns, bridges, dentures, implants - 1 year wait for coverage
Traditional Plan | 50% |
Braces
Traditional Plan | None |
Added benefits if you're at high risk of tooth decay or gum disease
Traditional Plan | Yes |
Covers diagnostic and preventive care beyond annual maximum benefit
Traditional Plan | Yes |
One time per person
Traditional Plan | $50 |
Per person per calendar year
Traditional Plan | $1,200 |
Our individual and family plan includes our innovative program that adds benefits based on each person's oral health needs. It's a patient-centered way to encourage better oral and overall health through preventive care.
Your dental plan does even more with Prevention Pays. Covering preventive care beyond the annual maximum benefit encourages regular dental visits to protect your smile and keep it healthy.
Our Individual and family plan features our Delta Dental PPO Plus Premier network. Enrolled members get a broad choice of dentists in two networks and lower out-of-pocket costs.
Prefer a paper form instead? Use this .PDF file of our Individual/Family Plan enrollment form.
Learn more about our Individual & Family Plan with our Frequently Asked Questions page.
Some things aren't covered by our Individual & Family Plan. See what they are on our Plan Exclusions page.
Download plan summaries, enrollment forms, and other files at our Document Library.