Dental
Dental Plan Highlights
Your dental plan is a Preferred Provider Plan administered by Delta Dental of Kansas.
Two levels of coverage are offered:
Basic Dental Plan
Provides benefits for diagnostic, preventive & basic care eligible charges (including exams, cleanings, fillings and X-rays).
Deductible |
$50 Per Person/$150 Per Family |
Preventive/Diagnostic |
100% (Not subject to deductible) |
Basic Services |
80% (After deductible) |
Major Services |
Not Covered |
Annual Benefit Maximum |
$750 Per Person |
Comprehensive Dental Plan
Provides all of the above preventive/diagnostic and basic coverage, plus offers coverage for a more extensive range of dental care including orthodontia.
Deductible |
$100 Per Person/$300 Per Family |
Preventive/Diagnostic |
100% (Not subject to deductible) |
Basic Services |
80% (After deductible) |
Major Services |
50% (After Deductible) |
Annual Benefit Maximum |
$1,500 Per Person |
| Orthodontia | 50% (After deductible) |
| Orthodontia Lifetime Maximum | $2,000 Per Person |
Preventive Services
- Routine Dental Examinations
Twice per calendar year - Cleaning
Twice per calendar year - Topical fluoride application for children under age 19
Twice per calendar year - Total mouth x-ray
Once every 36 months - Bitewing x-rays
Twice per calendar year
Basic Services
- Restorations (fillings)
Amalgam, silicate cement, acrylic and composite - Oral Surgery
Extractions (uncomplicated surgical removal of an erupted tooth), incision/drainage of abscess, cyst or tumor removal - General anesthesia and postoperative care
- Periodontics
Root planning/scaling, gingivectomy/gingivoplasty - Endodontics
Root canals (including necessary x-rays/cultures, excluding final restoration), denture or bridge work repairs
Major Services
- Inlays and crowns
- Artificial teeth
- Removable bridge
- Dentures