Delta Dental
(800) 765-6003
Dental Plan Option
Using the Plan
Dental benefits are another important element of your overall health. With proper care, your teeth can and should last a lifetime.
Santa Clara University provides dental care coverage through Delta Dental. Under this plan, you may receive care from any dentist you wish. If you obtain dental care services from a dentist who participates in the Delta Preferred Option (DPO) network, you may have the opportunity to save money.
Dentists participating in the Delta Preferred Option network agree to discount their charges, and benefits are based on discounted fees. You may locate a participating dental provider on the Delta Dental website or by calling (800) 765-6003.
You also have the option of obtaining dental care services from dentists who do not participate in the DPO network. Since the fees for Non-DPO dentists are not discounted (as they are with network providers), your out-of-pocket expenses may be greater.
PLAN HIGHLIGHTS |
DELTA DENTAL |
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IN-NETWORK |
OUT-OF-NETWORK (1) |
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General Information |
When you obtain dental services from network providers, you will receive higher coverage. |
You may receive dental care from any dentist you wish. If you receive care from non-network dentists, your coinsurance will be higher. |
Annual Deductible |
Waived for Preventive Care Services |
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Individual |
$25 |
$25 |
Family |
$75 |
$75 |
Annual Maximum Benefit |
$3,500 |
$3,500 |
Preventive Services |
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X-rays; Cleanings; Examinations |
Eligible Charges |
Eligible Charges |
Routine Basic Services |
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Amalgam Fillings; Extractions; Root Canals |
Eligible Charges |
Eligible Charges |
Major Services |
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Bridges; Dentures; Crowns, Implants |
Eligible Charges |
Eligible Charges |
Orthodontia Services (employee, spouse/domestic partner, and dependent children to age 26 only) |
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Eligible Charges Covered at 50%, up to a Lifetime Maximum of $3,000 |
Eligible Charges Covered at 50%, up to a Lifetime Maximum of $3,000 |
(1) Reimbursement is based on PPO contracted fees for PPO dentists, Premier contracted fees for Premier dentists and the program allowance for no-Delta Dental dentists.
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