Welcome Public Employees Benefit Board (PEBB)

 

You have chosen the DeltaCare® Plan

GROUP #03100

DELTA CARE PLAN
 
Requires primary care dentist (PCD) from the DeltaCare® network
DeltaCare® PCD must refer you for any specialized care
No deductibles
Fixed dollar copays
No coverage for out-of-network care
Responsive, local customer service
 

COPAY:  On the DeltaCare plan, you pay a fixed dollar amount for each treatment you receive.

 
 

Here's how to get the most from your coverage

STEP 1
Activate your MySmile® account
Easy, secure access to all your custom dental benefit information on your phone or desktop!
 
Print your ID card
Endorse your favorite DeltaCare dentist
Review your coverage
Accounts are available for subscribers and their dependents ages 18+
 
STEP 2
Find a primary care dentist (PCD) from the DeltaCare® network
Find a DeltaCare® PCD near you:
 
Find a Dentist Tool
Select 'DeltaCare' to filter your search results
Contact the dental office to confirm they're accepting new patients
If you want to change your PCD, you can do so at any time.
Find A Dentist from the DeltaCare® network
Call us at (800) 650-1583 and we'll make the change
Make your request by the 20th of the month to start seeing your new PCD on the 1st of the following month
 
STEP 3
Review your DeltaCare® costs
ANNUAL COSTS
 
Deductible   $0
Plan maximum   No annual maximum
 
YOU PAY PER SERVICE
 
Cleaning and exam every 6 months   $0
Fluoride treatment   $0
Complete x-rays every 3 years   $0
Fillings   $10 to $50
Crowns   $100 to $175
Root canals (endodontics)   $100 to $150
Treatment of gum disease (periodontics)   $15 to %100
Tooth extractions   $10 to $50
Orthodontia   up to $1,500 per case
Implants   $2800 per tooth
Dentures   $140 per arch
Nonsurgical TMJ   30% up to $1,000 per year or $5,000 lifetime annual maximum. Patient pays any cost exceeding lifetime annual maximum.
view and download your certificate of coverage