DENTAL
Proper dental care plays an important role in your overall good health. Invited offers two Dental Plans designed to encourage preventive treatment, allowing Employee Partners to achieve oral health while striving to minimize dental costs. Full-time Employee Partners may participate in the Dental Provider Organization (DPO) or Dental Health Maintenance Organization (DHMO), both of which are offered by Delta Dental.
DPO Network Dentists
You can see any provider to receive care; however, when using a network dentist, your out-of-pocket costs are lower. To find a network dentist, contact Delta Dental at www.deltadentalins.com (Delta Dental DPO option) or call 1-800-521-2651
DeltaCare USA (DHMO) Plan
You will need to select a contracted DeltaCare USA dentist for both you and your eligible dependents at the time of enrollment. You must receive treatment from your selected DeltaCare USA contract dentist in order for your dental services or treatment to be covered. To find a contract DeltaCare USA dentist, contact Delta Dental at www.deltadentalins.com (DeltaCare USA option) or call 1-800-422-4234.
| Plan Features |
DHMO |
DPO |
| States where Plan is offered |
AL, AR, AZ, CA, CO, DC, FL, GA, KS, KY, LA, MD, MI, MS, NV, NY, OH, PE, SC*, TN, TX, WA, WS, WV |
All States |
| Annual Maximum |
None |
$1,500/ind. |
| Annual Deductible |
None |
$50/ind; $150/fam. |
| Preventive Services (no ded.) |
$5 per visit |
100% |
| Basic Services Filing - Amalgam Filing - Resin |
No charge |
80% coinsurance (after ded.) |
| Major Services Crown - high noble metal |
$355 |
50% coinsurance (after ded.) |
| Orthodontia Adult Child |
$2,100 |
Not covered |
| Bi-Weekly Dental Rates | ||
|
Bi-Weekly DPO |
DHMO |
|
| Employee Only |
$16.54 |
$7.90 |
| Employee + Spouse |
$35.04 |
$13.56 |
| Employee + Child(ren) |
$34.36 |
$13.66 |
| Employee + Family |
$55.71 |
$19.68 |
DHMO Plan Highlights
DPO Plan Highlights
Dental Claim Form
Plan Links
www.deltadentalins.com/Invited
800-521-2651 – DPO
800-422-4234 - DHMO