This Delta Dental plan grants access to providersProviderAn individual or facility that provides health care services such as a doctor, nurse, chiropractor, hospital, rehabilitation center, etc. only within the Delta Preferred Provider Option (PPO) networkPreferred Provider Organization (PPO)A health care plan that has a contractual agreement with providers to offer health care services at discounted, negotiated fees within a network. The PPO plans may require some cost-sharing with deductibles, copays and/or coinsurance. . Your PPO networkNetworkThe facilities, providers and suppliers with whom your health insurer or plan has contracted to provide health care services is available in Colorado and throughout the United States.
Essential Plan members must see a PPO providerPreferred Provider Organization (PPO)A health care plan that has a contractual agreement with providers to offer health care services at discounted, negotiated fees within a network. The PPO plans may require some cost-sharing with deductibles, copays and/or coinsurance. . Coverage will not be offered for providersProviderAn individual or facility that provides health care services such as a doctor, nurse, chiropractor, hospital, rehabilitation center, etc. outside of the network.NetworkThe facilities, providers and suppliers with whom your health insurer or plan has contracted to provide health care services Once you meet the $25 per person plan deductibleDeductibleAn amount that you are required to pay before the plan will begin to reimburse for covered services., you’ll be responsible for a percentage of your covered care costs, known as coinsurance.CoinsuranceThe portion of expenses that you have to pay for certain covered services, calculated as a percentage. For example, if the coinsurance rate is 20%, then you are responsible for paying 20% of the bill, and the insurance company will pay 80%.
Plan Details
Features & Considerations | |
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Plan Type | PPO Provider Network |
Plan-Year Benefit | $2,000 per person |
Deductible (Children under 13 excluded) | $25 per person |
Preventative & Diagnostic Services | 0% coinsurance & non deductible |
Basic Services | 30% coinsurance payment |
Major Services | 50% coinsurance payment |
Orthodontics (for children under age 19) | 50% coinsurance payment |
Orthdontics for adults (19 and older) | Not covered |