Plans for Retirees
Individual and Family Dental Plans for Retireesi
Scroll down within the table to view all benefits.
| Plan features | Optimum Plan |
Premium Plan |
Ascent Plan |
Enhanced Plan |
Simple |
|---|---|---|---|---|---|
| Description | NEW for 2027. Cosmetic benefits and highest cost-sharing for restorative and major services |
High maximum and three periodontal maintenance cleanings per benefit year |
No waiting period and coverage that increases over the first two years you renew |
100% coverage on most preventive care services and 50% on most major procedures |
NEW for 2027. Fixed out-of-pocket costs, no deductible, no copays, and no plan year maximum |
| Shop plans | |||||
|
$97.30ii |
$74.40ii |
$63.60ii |
$55.40ii |
$44.05iii |
|
$111.70ii |
$85.50ii |
$73.15ii |
$63.75ii |
$55.40iii |
|
1st Yr, 2nd Yr, 3rd Yr |
$2000 |
1st Yr, 2nd Yr, 3rd Yr |
$1000 |
None |
None |
None |
None |
None |
None |
|
$100 |
$100 |
$50 |
$50 |
None |
|
None |
None |
None |
None |
None |
|
|
100% |
100% |
100% |
100% |
$85 Copay |
80% |
80% |
1st Yr, 2nd Yr, 3rd Yr |
50% |
$125 Copay |
|
60%iv |
50%iv |
50%iv |
50%iv |
||
60% |
50% |
50% |
50% |
||
60% |
50% |
50% |
50% |
||
60% |
50% |
50% |
50% |
$125 Copay |
|
60% |
50% |
Not Covered |
Not Covered |
$240 Copay |
|
60%vii |
50%vii |
1st Yr, 2nd Yr, 3rd Yr |
50% |
Included in Preventive Care Visit |
|
Not Covered |
Not Covered |
Not Covered |
Not Covered |
Not Covered |
|
50% teeth whitening or bleaching |
Not Covered |
Not Covered |
Not Covered |
Not Covered |
|
Yes |
Yes |
Yes |
Yes |
Yes |
|
May Applyviii |
May Applyviii |
None |
May Applyviii |
May Applyviii |
Optimum Plan |
Premium Plan |
Ascent Plan |
Enhanced Plan |
Coverage percentages displayed in the table above represent the percentage of the allowed amount that is covered by Delta Dental of Washington.
Not sure which dental plan is right for you? Try our
Interactive Plan Finder
Plan Finder only for Individual and Family Dental Plans. Does not include DeltaVision® or Affordable Care Health Act Plans.
Individual DeltaVision® Plans
Choose from our standard DeltaVision® Essential Plan 150 or our premium DeltaVision® Brilliance 200 Plan, available to add to your new dental plan at checkout or to your current dental plan at any time.xi xii xiii
For more information about our DeltaVision® Plans or to add vision to your dental plan, please call us at 844-764-5350.
| DeltaVision® Brilliance 200 Plan |
DeltaVision® Essential 150 Plan |
|
|---|---|---|
| Monthly Premium Individual Starting Ratei |
$15.55 | $12.50 |
| WellVision Exam® Copay benefit frequency every 12 months |
$0 | $10 |
| Prescription Glasses (frames, lenses) Copay benefit frequency every 12-months |
$0 | $10 |
| Retail Frame Allowance included in prescription glasses benefit frequency every 12-months |
$200 | $150 |
| Costco/Walmart Frame Allowance | $110 | $80 |
| Lenses (single vision, lined bifocal and lined trifocal)
included in prescription glasses copay |
Covered | Covered |
| Polycarbonate Lens Enhancements for Children Copay included in prescription glasses copay |
$0 | $0 |
| Contact Lens Exam Copay Maximum fitting and evaluation |
$0 | $40 |
| Elective Contact Lenses Allowance in lieu of glasses |
$200 | $150 |
| Percentage Saved on Purchases over the Plan Allowance for Frames within 12 months of last WellVision® exam |
20% | 20% |
| Out-of-Network Providers |
Not covered | Not covered |
VSP, eyeconic.com, and WellVision Exam are registered trademarks of Vision Service Plan.
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.
iii. Individual 12-month contracted rate for ages 51+. Actual rate may be higher or lower depending on age.
iv. 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. Crowns covered at 60% per tooth every seven years for persons ages 12 years and older under the Delta Dental - Optimum Plan.
v. A pretreament estimate is suggested. Clinical requirements must be met; 1 crown and 1 implant per person per 12-month policy period.
vi. 2 teeth in 12 months after purchase or renewal, once per tooth every two years after.
vii. No waiting period.
viii. 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.
ix. Eligibility: Vision benefits are only offered in conjunction with Delta Dental of Washington individual dental plans sold through Delta Dental Covers Me. All other eligibility requirements are shared with the dental plan.
x. Administration: We make it easy to pair dental and vision benefits. Application, enrollment and billing processes are coordinated for your convenience through Delta Dental Covers Me.
xi. Enrollment: You may enroll in vision benefits up to 2 months prior to the requested effective date. After your application is approved, your coverage starts the first day of the month and continues for 12 months.
