Who's Eligible: Employees eligible for full benefits and retirees
Who’s covered: You and your eligible family members
Who pays the premium: UC and retirees subject to graduated eligibility
What the Plans Cover
Delta Dental PPO
The Delta Dental PPO plan, available worldwide, provides you and your family with the flexibility to choose any licensed dentist or specialist. Your share of the cost of services depends on whether you use a dentist in Delta Dental’s PPO network or an out-of-network dentist.
If you choose a PPO dentist, you will usually pay less for services. PPO dentists agree to accept a reduced fee for services, and the dentist will complete and submit all claim forms for you at no charge. Preventive dentistry — exams and cleanings — is free of charge; basic dentistry, such as fillings and extractions, is covered at 80 percent after you meet the $50 annual deductible, and most other dental care is covered at 50 percent, up to $1,700 per year.
Delta has more than 43,700 PPO dentists in California and 234,000 nationwide. To see a list of Delta Dental PPO dentists, visit the Delta Dental website.
Delta’s Premier dentists are not in the PPO network but have agreed to accept a reduced fee for services and also will complete and submit claim forms for you. Delta Dental covers 75 percent of basic dentistry costs after annual deductible if you use a Premier dentist, up to $1,500 per year. If you go to a dentist not affiliated with Delta Dental, you may have to pay the dentist’s total fee and then submit your claim form to Delta Dental for reimbursement. Delta cannot assure you what percentage of the charged fees may be covered.
DeltaCare® USA is a dental HMO that provides you and your family with comprehensive benefits and easy referrals to specialists. You must live in California to enroll.
The plan stresses preventive care, so many preventive services are provided at no cost. Other services are provided for modest copayments with no deductibles or annual plan maximum.
When you enroll, you select a network dentist to provide all your basic dental services and to refer you to specialists when necessary. The DeltaCare® USA network consists of private practice dental facilities that have been screened by Delta Dental for quality. Some areas of California have more network providers than others, so be sure there are dentists available in your area before choosing this plan.
You may change your dentist at any time by calling the Delta Care Customer Service number to request the change. Visit the DeltaCare website for a list of participating dentists.
Cost of Coverage
UC pays 100 percent of monthly dental plan premium for employees and for retirees eligible for the full UC contribution. Retirees subject to graduated eligibility pay a portion of the premium. UC’s contribution toward the monthly cost is determined by UC and may change or stop altogether. You pay a certain percentage or copayment for some services.