Healthy teeth and gums are important to your overall wellbeing. To help you maintain your dental health and address any issues, our dental coverage through Delta Dental of Michigan pays for most preventive and diagnostic care and helps pay for the cost of basic and major restorative treatments. The plan also provides orthodontia benefits for dependents up to the age of 19 (unless they are medically necessary).
You'll generally pay less out-of-pocket when you use an in-network dentist. Visit Delta Dental of Michigan for more information.
Learn how using in-network providers can help you save here.
Feature | Amount |
---|---|
Deductible | |
Employee only | $50 |
Employee + spouse/declared domestic partner
or
Employee + child
|
$100 |
Employee + children or Employee + family (Employee + spouse/declared domestic partner + child(ren)) | $150 |
Annual maximum benefit paid per calendar year excluding orthodontics | $2,000 |
Lifetime maximum benefit paid for orthodontics | $2,000 |
Services | |
Class I benefits:
Diagnostic and preventive services (includes exams, cleanings, fluoride and space maintainers); emergency palliative treatment; sealants; radiographs/X-rays; periodontal cleanings
|
You pay $0 |
Class II benefits:
Minor restorative services (includes fillings); periodontic services (to treat gum disease); endodontic services (includes root canals); oral surgery services (extractions and dental surgery); relines and repairs (to bridges and dentures); other basic services
|
You pay 20%, plan pays 80% |
Class III benefits:
Major restorative services (includes crowns); prosthodontic services (includes bridges and dentures); implants (endosteal implants to replace missing teeth)
|
You pay 50%, plan pays 50% |
Class IV benefits: Orthodontic services (includes braces) Note: Orthodontic age limit is 19 unless medically necessary. | You pay 50%, plan pays 50% |
With your dental plan, you have the freedom to choose any licensed dentist for care. However, if you choose a Delta Dental Premier or Delta Dental PPO dentist, you will pay only your copayment for covered services. To find a Delta Dental Premier or Delta Dental PPO dentist, check Delta Dental of Michigan’s web site.
Here’s how to make the most of your dental benefits:
Visit Delta Dental of Michigan to download additional forms.