Adult Dental Services (for Members age 19 and older)

 At Participating Providers, You Pay

  All dental services are subjected to an annual maximum of $1,000 per Plan year. No services are subject to a Deductible.

  Diagnostic & Preventive

  (Limited to 1 every 6 months)

 No charge

  Basic Dental Services

 50% Coinsurance

  Major Dental Services

  (Available after 6 consecutive months of enrollment)

 50% Coinsurance

  Orthodontics

  Medically necessary orthodontics and accidental dental are covered under Medical benefits.

 Not Covered

 Waiting Periods are calculated for each Adult Enrollee from the effective date of coverage reported by the Exchange for said Adult Enrollee. Prior coverage for Adult Enrollees under any Delta Dental Exchange plan that included an adult Waiting Period will be credited towards the adult Waiting Period under this dental plan. In order for prior coverage to be credited, such prior coverage must occur immediately preceding the election of this plan.