|Plan year maximum
|$175.70 - $201.95*||$1,500
Family Share Maximum Benefit – An additional $250 maximum benefit per person up to $1,250
|$50 annually, per covered person|
|Office visit copay
Cleanings, exam, x-rays, and fluoride
|Crowns||Root canal||Non-Surgical Extractions & Implants|
|Gum disease deep cleaning||Orthodontics||Waiting Periods|
($1,500 lifetime maximum w/ 12-month waiting period)
*For Orthodontia covered procedures a 12-month waiting period applies. This means that DDWA will not pay towards any of these procedures until the covered members have been enrolled in this policy for 12 continuous months. The waiting period for Orthodontia treatment will be waived for your family if all family members were covered under another insured dental plan with orthodontic coverage for at least 12 continuous months before you enrolled in this plan, but only if there was no more than a 63-day gap between the previous plan and this plan. Documentation is required to waive the 12-month waiting period.
**These are benefit highlights only. Monthly premiums shown are examples only of our lowest monthly rates for subscriber-only or family, (subscriber, spouse, plus two children) in Washington, effective January 2022. Actual rates vary based on plan choice, your age, your location, number of people insured, their age, and relationship to you. Waiting periods may be waived if you had qualifying dental coverage for 12-continuous months prior to enrolling. For full details of plan, benefits and pricing, please visit DeltaDentalCoversMe.com.