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Dental – Delta Dental
Regular visits to your dentist can protect more than your smile; they can help protect your health. Recent studies
have linked gum disease to damage elsewhere in the body and dentists are able to screen for oral symptoms of
many other diseases including cancer, diabetes, and heart disease.
TID provides you with a comprehensive coverage through Delta Dental of California.
Dental Base Plan
Dental Base Plus $1K Plan
Calendar Year
Deductibles
$25 per person
$50 per family
$25 per person
$50 per family
Calendar Year
Plan
Maximums
PPO Dentists: $2,100
Non-PPO Dentists: $2,000
PPO Dentists: $3,100
Non-PPO Dentists: $3,000
Waiting Period
Basic Benefits
None
Major Benefits
None
Prosthodontics
12 Months
Benefits and Covered
Services
Delta Dental¹
PPO Dentists
Non-PPO²
Dentists
Delta Dental¹
PPO Dentists
Non-PPO²
Dentists
Diagnostic and Preventive
(D&P)
Exams, cleanings and x-rays
100%
100%
100%
100%
Basic Services
Fillings, simple tooth
extractions, sealants and
night guards
80%
80%
80%
80%
Endodontics
(root canals)
Covered under basic services
80%
80%
80%
80%
Periodontics
(gum
treatment)
Covered under basic services
80%
80%
80%
80%
Oral Surgery
Covered under basic services
80%
80%
80%
80%
Major Services
Crowns, inlays, onlays and cast
restorations
50%
50%
60%
60%
Prosthodontics
Bridges, dentures and
implants
50%
50%
60%
60%
¹Limitations or waiting periods may apply for some benefits, some services may be excluded from your plan. Reimbursement is based on
Delta Dental maximum contract allowances and not necessarily each dentist’s submitted fees.
²Reimbursement is based on PPO contracted fees for PPO dentists, Premier contracted fees for Premier dentists and program allowance for
non-Delta Dental dentists.