Group Number
91142000
Provided By
Delta Dental of Missouri
Provider Website
Customer Service
Resources
Frequently Asked QuestionsDental Benefits
Dental insurance offers coverage for preventive care like routine exams, cleanings, and X-rays as well as basic and major services like fillings, extractions, root canals and crowns.
Keep in mind that your costs will generally be lower if you choose an in-network dentist. To find an in-network dentist, please visit deltadentalmo.com.
PPO |
Premier |
Non-Participating |
|
|---|---|---|---|
Deductible (Individual/Family) |
$25 / $75 |
$50/ $150 |
$50/ $150 |
Annual Benefit Maximum Per Person |
$1,200 |
$1,200 |
$1,200 |
Services |
|||
Type I - Preventative Services |
90% |
80% |
80% |
Type II - Basic Services |
90% |
80% |
80% |
Type III - Magor Services |
60% |
50% |
50% |
Type IV - Orthodontia Services |
50% |
50% |
50% |
Orthodontia Lifetime Max |
$1,000 |
$1,000 |
$1,000 |
Dependent Limiting Age |
26 |
26 |
26 |
Per Pay Period Cost (26) |
|
|---|---|
Employee |
$4.96 |
Employee + Spouse |
$16.10 |
Employee + Child(ren) |
$14.22 |
Family |
$18.41 |
Group Number
91142000
Provided By
Delta Dental of Missouri
Provider Website
Customer Service
Resources
Frequently Asked Questions