Which Coverage Level Is Best?
You get to choose how much coverage you need and how you want to pay for it. When you choose your coverage level, you get to pick the one with the features you want.
Your coverage level determines how much you pay out of your paycheck (premiums). It also determines how much you pay out of your pocket when you receive care (deductibles, coinsurance, copays). Make sure to take your total costs into consideration when choosing a coverage level.
Don’t let the names of the coverage levels fool you. One option isn’t better than another. The coverage levels are designed to give you choices. It’s up to you to find the one that makes sense for your situation.
Dental Coverage Level Options
Bronze | Silver | Gold | Platinum2 |
---|
Annual deductible (individual / family) |
$100 / $300 |
$100 / $300 |
$50 / $150 |
None |
Annual maximum (excludes orthodontia) |
$1,000 per person |
$1,500 per person |
$2,500 per person |
None |
Orthodontia lifetime maximum1 |
Not covered |
$1,500 per child |
$2,000 per person |
Varies by insurance carrier |
Preventive care |
100% covered, no deductible |
100% covered, no deductible |
100% covered, no deductible |
Varies by insurance carrier; generally covered 100% |
Minor restorative care (e.g., root canal treatment, gum disease treatment, and oral surgery) |
You pay 20% after deductible |
You pay 20% after deductible |
You pay 20% after deductible |
Varies by insurance carrier |
Major restorative care (e.g., crowns, implants, dentures) |
Not covered |
You pay 40% after deductible |
You pay 20% after deductible |
Varies by insurance carrier |
Orthodontia |
Not covered |
You pay 50%, no deductible; children up to age 19 only |
You pay 50%, no deductible; for children and adults |
Varies by insurance carrier |
Considering Platinum? It may cost less than some of the other options, but you must designate a primary care dentist who participates in the insurance carrier’s Platinum network (where available by carrier) and get care from your primary care dentist. The network could be considerably smaller, so be sure to check the availability of local in-network dentists before you enroll. If you don’t designate a primary care dentist when you enroll, one may be assigned to you. To change your primary care dentist, you will need to contact the insurance carrier directly. If you enroll in a Platinum option and don’t use a network dentist, you’ll pay for the full cost of services.
Considering Delta Dental? With most carriers, knowing that your dentist is in the network is a simple way to get the best deal when you need care. If you're considering Delta Dental, you need to take it one step further.
- If you choose a Bronze, Silver, or Gold option, there are actually two Delta Dental networks—PPO and Premier. Although the benefits are the same for both, you may have to pay more if your dentist is only a part of the Premier network. You can save more by seeing a Delta Dental dentist who participates in both the PPO and Premier networks, or by using any in-network dentist if you choose another insurance carrier on the exchange.
- If you choose a Platinum option, the Delta Dental network goes by the name of “DeltaCare.” So you need to make sure your dentist is in the DeltaCare network—not just the Delta Dental network. You can also get the same deal by using any in-network dentist if you choose another insurance carrier on the exchange.
You can check if your provider is part of either network on asurion.benefitsnow.com or through Your Carrier Connection.