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Delta Dental Premier Summary

This popular, traditional fee-for-service product offers members access to the largest dental network available in Oregon and across the nation. Members can save money by seeking care from participating Premier providers.

Benefit Summary

*Waiting period may be waived by creditable prior coverage from a comparable plan.

This is a benefit summary only. For a complete description of benefits, refer to your Policy. Effective November 1, 2009 through October 31, 2010
Plan yearThe 12-month period commencing on the effective date and each 12-month period thereafter. maximum, per member $750: 1st year
$1,000: 2nd year
$1,250: 3rd year
Plan year deductible, per member $50
Service Benefit
  Premier Network
Class 1: Examinations/X-rays (routine exam and bitewing X-rays once every six months); prophylaxis (cleanings once every six months); fissure sealants; fluoride 80%
Class 2: Restorative dentistry (treatment of tooth decay with amalgam, synthetic porcelain and plastic materials); space maintainers 80%
Class 3: Oral surgery (surgical extractions and certain minor surgical procedures); endodontics and periodontics; 12-month waiting period on major services*: crowns; cast restorations; dentures and bridge work (construction or repair of fixed bridges, partials and complete dentures) 50%