Dental Benefits

Good dental health is important to your overall well-being. At the same time, we all need different levels of dental treatment. It is for this reason that Stevens offers two dental plans through Delta. These plans offer a wide range of dental benefits, from routine preventive and basic care to major services and orthodontia. The PPO dental plan allows you to use any dental provider, however, you will receive greater benefits (less out-of-pocket costs) when a participating dentist performs covered dental services. The DMO plan requires that you visit participating DMO providers in order to be covered. Dental benefits are provided to eligible dependents up to age 26.

PPO PLAN

In the PPO plan, you have the choice to use a dental provider outside the network but your out-of-pocket cost will be less if you use a preferred provider in Delta Dental’s PPO or Premier networks. Delta Dental PPO providers offer deeper discounts than Delta Dental Premier providers. Claim forms are not required when utilizing in-network providers. Network participating providers accept negotiated rates which reduce your claim costs and out of pocket expenses. If you choose a non-network dentist, the plan will reimburse you a percentage of the allowable charge.

DMO PLAN

You are required, as a DMO member, to select a Primary Care Dentist (PCD) from participating dentists in the DMO network. You must use your selected PCD for all dental services or obtain a referral from your PCD to obtain services from a specialist. The amount you pay for services rendered is based on the plan’s benefit fee schedule. Orthodontia coverage is offered for adults and children according to the plan’s fee schedule. Please contact Delta Dental for more information.

DENTAL HIGHLIGHTS

PPO PLAN

PPO PLAN

DMO PLAN

 

In-Network

PPO & PPO Premier

Out-of-Network

In-Network

Annual Deductible Individual/Family

PPO: $25 / $75 PPO Premier: $50 / $150

$50 / $150

No Deductible or Office Visit Copay

Annual Maximum Benefit (Excludes Preventive and Diagnostic Services)

$2,000

$2,000

No Annual Maximum

Preventive Services

100%, no deductible

100%, no deductible

No Charge

Basic Services Fillings, Endodontic Treatment and Periodontic Treatment

80%

80%

Copays apply (refer to the DMO Benefits Summary for applicable copays)

Major Services Crowns and Dentures

50%

50%

Copays apply (refer to the DMO Benefits Summary for applicable copays)

Orthodontia (Child & Adult)

50%, $2,000 Lifetime Maximum

50%, $2,000 Lifetime Maximum

$2,300 Treatment copay

Finding a Provider

To find a participating provider near you, please contact Delta through one of the methods below.

Contact information
PPO Plan: deltadentalnj.com | 800-452-9310

DHMO Plan: deltadentalins.com | 800-422-4234