This plan is designed for individuals who want to know their exact out-of-pocket treatment costs before heading to the dentist. With set dollar amounts, you can easily plan and track how much you are investing in your oral health.
Learn why the SimpleChoice Plan is a great fit for seniors and retirees who wish to know their dental costs ahead of time.
Betty (65), Bellingham – Recent retiree seeking dental benefits for her and her husband
Betty just retired and enrolled in a Medicare Advantage plan, but she only receives limited dental benefits through the program.
I am enjoying my life as a new retiree and am excited to spend unlimited time gardening with my husband and going for long hikes. As soon as we decided to retire, I signed us up right away for a Medicare Advantage plan. But we’ve learned that our Medicare plan really doesn’t cover most of our needs. As we age, I want to make sure that our teeth are well taken care of and covered so that we don’t rack up a huge dental bill later. As someone who likes to know upfront exactly how much something costs, I knew that this plan was the best fit for our dental and budgeting needs.
José (69), Issaquah – Longtime retiree who is enrolled in a traditional Medicare plan and needs comprehensive dental coverage
José needs a few dental procedures done that are not covered by Traditional Medicare.
When I enrolled in a traditional Medicare plan at age 65, I was shocked to learn that dental benefits were not included. I thought Medicare was built to help me with all my healthcare needs as I age. While I haven’t encountered many dental issues overall, my dentist told me I need a couple of fillings and a root canal. I am on a limited income, so I want to make sure I invest in a dental plan that is intuitive, affordable, and inclusive of my dental needs. I am glad I found a plan where I don’t have to estimate costs and thus know exactly how much my next treatment is going to cost!
*Personas are fictional and only intended to represent possible oral health needs and situations. They are not inclusive of all needs or circumstances.
SimpleChoice Plan features per benefit year. Monthly rates are listed Western Washington first, then Eastern Washington.
The fixed rate you pay to Delta Dental of Washington monthly in exchange for coverage.Western/Eastern WA
The maximum your dental plan will pay for your dental care in one plan year.per person
An added shared maximum available under some plans.
Individual Starting Rateii $55.40 / $44.05Actual rate may be higher or lower depending on age.
None
None
The money you pay out of your own pocket to your dentist before your dental benefits plan kicks in.
A preset amount you are required to pay before receiving a service or treatment covered by your dental insurance provider. This is the amount you pay to the dentist for certain procedures each time you visit.
Regular checkups - cleanings, exams, x-rays and fluorides - that help stop problems before they start.Cleanings, exams, x-rays, and fluoride
None
None
$85 Copay
Replacement of lost tooth structure, typically with a silver or white restorative material.
A restoration that replaces the entire visible portion of the tooth.
Removal of the pulp or nerve from inside a tooth and replacement with a filling material.
$125 Copay
$800 Copayiv1 crown per person per 12-month policy period
$600 Copay 2 teeth in 12 months after purchase or renewal, once per tooth every two years after
Artificial replacement for the root or roots of a missing tooth.
Tooth removal that does not require sectioning (cutting) of a tooth or removing bone.
Tooth removal requiring sectioning (cutting) of a tooth or removing bone.
$2750 Copayiv1 implant per person per 12-month policy period
$125 Copay
$240 Copay
A periodic cleaning following treatment for advanced gum disease to preserve the health of the gums and bone that support the teeth.
Terms and conditions apply for 12 months from the policy effective date.
The time before all of your dental benefits are payable by Delta Dental of Washington.
The maximum your dental plan will pay for your dental care in one plan year.per person
None
$1000
1st Yr, 2nd Yr, 3rd Yr$1000/$1250/$1500
An added shared maximum available under some plans.
None
None
None
The money you pay out of your own pocket to your dentist before your dental benefits plan kicks in.
None
$50
$50
A preset amount you are required to pay before receiving a service or treatment covered by your dental insurance provider. This is the amount you pay to the dentist for certain procedures each time you visit.
None
None
None
Regular checkups - cleanings, exams, x-rays and fluorides - that help stop problems before they start.Cleanings, exams, x-rays, and fluoride
$85 Copay
100%
100%
Replacement of lost tooth structure, typically with a silver or white restorative material.
$125 Copay
50%
1st Yr, 2nd Yr, 3rd Yr50%/60%/70%
A restoration that replaces the entire visible portion of the tooth.
$800 Copayiv1 crown per person per 12-month policy period
Can I see the cost of treatment before receiving care?
Yes. The SimpleChoice Plan includes set copays for listed covered services, which can make costs easier to anticipate. For planned treatment, especially crowns, root canals, implants, or extractions, members should request a pretreatment estimate from their dentist to confirm coverage and expected out-of-pocket costs.
What is a copay?
A copay, or copayment, is a preset amount you are required to pay before receiving a service or treatment covered by your dental insurance provider. Learn more about copays here.
Under the SimpleChoice Plan, there is no office visit copay and so you do not owe any money before seeing your dentist. However, there are set copays for receiving procedures as outlined in the Plan Features table.
What is a deductible?
A deductible is the money you pay out of your own pocket to your dentist before your dental benefits plan kicks in. Learn more about deductibles here.
Under the SimpleChoice Plan, there is no deductible and so your dental benefits plan starts as soon as you have met the waiting period requirements.
What does an annual maximum for dental mean?
An annual maximum (also known as a plan year maximum) is the maximum your dental plan will pay for your dental care in one plan year. After you hit that amount, you’ll need to pay for any other dental services yourself until your benefits reset. Learn more about annual maximums here.
Under the SimpleChoice Plan, there is no annual maximum and so your dental plan will continue to pay for your dental care as long as you stay enrolled in the plan.
Does the SimpleChoice Plan cover extractions?
Yes. The SimpleChoice Plan is a recommended dental plan for extractions. There is a $125 copay for non-surgical extractions and a $240 copay for surgical extractions. Note that the type of extraction and applicable clinical requirements should be confirmed with the treating dentist and plan documents before treatment.
Does the SimpleChoice Plan cover wisdom teeth removal?
Yes. The SimpleChoice Plan is a great dental plan for wisdom teeth removal, covering both non-surgical and surgical extractions. There is a $125 copay for a non-surgical extraction and a $240 copay for a surgical extraction. We highly recommend getting a pretreatment estimate from your dentist prior to getting your wisdom teeth removed so that there are no unexpected costs or surprises.
Is the SimpleChoice Plan a good dental plan for root canal coverage?
i These are benefit highlights only. Monthly premiums shown are examples of monthly rates for subscriber only in Washington, effective January 2027. Actual rates may vary (higher or lower) based on plan effective date, plan choice, your age, your location, number of people insured, their age, and relationship to you. For full details of plan, benefits, and pricing, please visit DeltaDentalCoversMe.com.
ii Individual 12-month contracted rate for ages 51+. Actual rate may be higher or lower depending on age.
iii Individual 12-month contracted rate.
iv A pretreament estimate is suggested. Clinical requirements must be met; 1 crown and 1 implant per person per 12-month policy period.
v A pretreament estimate is suggested. Clinical requirements must be met, crowns covered at 50% per tooth every seven years for persons ages 12 years and older.
vi This Policy has a 12-month Waiting Period that applies to certain covered procedures. This means that Delta Dental of Washington will not pay for any of these procedures until you have been enrolled in this Policy for 12 continuous months. If you were covered under a comparable full-coverage dental plan that included Major services, for at least 12 continuous months before enrolling in this Plan, any Waiting Periods will be waived—provided there was no more than a 63-day gap between your previous coverage and this Policy. To request that the waiting period be waived, you must provide details about your previous coverage.
