Dental Insurance Coverage

The table below shows an overview of what each dental plan covers. See our Which Dental Plans are Available to Me? page to find out which plans are available to you. To see more comprehensive information, view plan documents or go to Delta Dental's website.

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Coverage	Uniform Dental & Preventive Plan	Select Plan	Select Plus Plan
In-Network providers (No out-of-network coverage)	Delta Dental PPO & Premier providers	Delta Dental PPO	Delta Dental PPO & Premier providers
Annual deductible	None	$100 / person	$25 / person
Annual benefit max	$1,000 / person	$1,000 / person	$2,500 / person
Waiting period	None	None	None
Routine evaluations, dental cleanings, sealants, bitewing and panoramic X-rays, fluoride treatments, pulp vitality tests	100%	No coverage	No coverage
Fillings	100%	No coverage	No coverage
Anesthesia (general and IV sedation)	80%	50%	80%
Emergency pain relief	80%	No coverage	No coverage
Periodontal maintenance	100%	No coverage	No coverage
Crowns, bridges, dentures, implants	No coverage	50%	60%
Surgical extraction, root canal (endodontics), periodontics (except maintenance), oral surgery	No coverage	50%	80%
Non-surgical extractions (above gumline)	90%	No coverage	No coverage
Orthodontics coverage	50% (Under age 19)	No coverage	50% (Any age)
Orthodontics lifetime maximum	$1,500	No coverage	$1,500

*Some services are subject to frequency and age limitations. See the Summary Plan Description or Handbook for details.

Frequently Asked Questions

There are a few instances where major dental care due to an injury would be covered by your medical insurance. However, in most cases dental care will not be covered by your medical insurance. If you have any questions about a dental injury being covered under medical or dental coverage, please contact Delta Dental at 1-844-337-8383 and your medical insurance provider. Remember for any dental injury to be covered under your dental insurance the medical professional must be Delta Dental of Wisconsin’s network.