Marvell Benefits

	Dental Base Plan		Dental BUY-UP Plan
	*Delta Dental PPO* *In-Network Dentist*	Delta Dental Premier & Out-of-Network Dentist	PPO In-Network Dentist ONLY
Deductible	$50/Individual $150/Family		$50/Individual $150/Family
Benefit Maximum _{(calendar year)}	Plan pays $2,000/Individual		Plan pays $3,000/Individual
Diagnostic and Preventive Benefits _{(oral exams, cleanings, X-rays, etc.)*}	No copay or deductible	Deductible applies	No copay or deductible
Basic Benefits _{(oral surgery, fillings, root canals, etc.)}	You pay 20%		You pay 20%
Crowns, Other Cast Restorations	You pay 50%		You pay 40%
Prosthodontic _{(bridges, full and partial dentures)}	You pay 50%		You pay 40%
Implant	You pay 50% with a $2,000 lifetime max/Individual		You pay 40% with a $3,000 annual maximum/Individual
Orthodontic Benefits _{(adults and children)}	You pay 50% with a $2,000 lifetime max/Individual		You pay 40% with a $3,000 lifetime maximum/Individual

_{* Not subject to benefit maximum.}

Fees are based on Delta’s PPO fees for in-network dentists and the maximum plan allowance (MPA) for out-of-network dentists.

Buy-Up Plan

You have the option to buy a higher level of dental coverage in addition to the Basic Plan. This option offers more coverage for major services, higher annual maximums per patient, a $3,000 annual maximum for implants, and a higher lifetime maximum for orthodontics (see full comparison chart for more details).

Please note that the Delta Buy-Up coverage is only available with Delta PPO dentists. PPO Premier dentists are considered out-of-network and your Buy-Up coverage would not apply.

Carefully review the benefits of the Buy-Up Plan and weigh against the increased monthly premium for the plan.

In-Network vs. Out-of-Network Dentists

Under the Delta Dental PPO Plan, you can visit any licensed dentist but you save money when using dentists within the PPO Network since PPO dentists have lower contracted fees and may only charge a set amount. When seeing a PPO dentist you will receive free diagnostic and preventive care and pay less for basic benefits, crowns, and other services.

Out-of-Network dentists tend to charge higher rates, and Premier dentists have a higher contracted rate with Delta, and so you'll pay more out-of-pocket and meet your benefit maximum quicker.

Since you pay a percentage of the dental bill, it’s in your best interest to see in-network Delta Dental PPO providers in order to minimize your out-of-pocket costs and maximize your annual plan allowance.

Dental Cost Estimator

Dental ID Card

Coordination of Benefits