USA Benefits

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Dental

Dental Buy-Up Plan Ending December 31, 2024
The Delta Dental Buy-Up Plan will no longer be offered as a dental care option. The Delta Dental PPO Plan (currently called the Delta Dental Base Plan) will continue to be offered. If you’re currently enrolled in the Delta Dental Buy-Up Plan and you do not make a change for 2025, you and your covered dependents will automatically be enrolled into the Delta Dental PPO Plan. Find more information about the change on the Open Enrollment 2025 page.

 Dental Base Plan Dental Buy-Up Plan

 

Delta Dental PPO, Delta Dental Premier and 
Out-of-Network Dentist
Delta Dental PPO, Delta Dental Premier and
Out-of-Network
Deductible $50/person
$150/Family
$50/Person
$150/Family
Benefit Maximum
(calendar year)
 Plan pays $2,000/Person

Plan pays $3,000/Person

Diagnostic and Preventive Services*
(oral exams, cleanings, X-rays)
No copay or deductible No copay or deductible 
Basic Services
(oral surgery, fillings, root canals, etc.)
You pay 20% You pay 20% 
Major Services
(crowns, onlays, gum treatment, cast restorations, etc.)
You pay 50% You pay 40% 
Prosthodontic
(bridges, full and partial dentures)
You pay 50% You pay 40%  
Dental Guards
(once every three years)
You pay 50%, Plan pays $500
maximum/Person
You pay 50%, Plan pays $500
maximum/Person  
Retainer Replacement 
(once every five years)
You pay 50%, Plan pays $500
maximum/Person
You pay 50%, Plan pays $500
maximum/Person 
Implants You pay 50%, Plan pays $2,000
annual maximum/Person
You pay 40%, Plan pays $3,000
annual maximum/Person
Orthodontic Benefits
(adults and children)
You pay 50%, Plan pays $2,000
lifetime maximum/Person
You pay 40%, Plan pays $3,000
lifetime maximum/Person
Reimbursement is based on PPO-contracted fees for PPO dentists, Premier-contracted fees for Premier dentists, and enhanced-program allowance for out-of-network dentists. Balance billing may still apply for out-of-network dentists.
  • View 2024 network comparison here.