Page 17 - Gray_2020 Benefit Guide
P. 17
Quick Contact Details:
PHONE: 800-955-2030
Your Health WEBSITE: deltadentalky.com
DELTA Login to your Delta Dental
account at deltadentalky.com
DENTAL Download Delta Dental Mobile
in the App Store or Google Play
Smile! You have access to a large network of dentists
through our Delta Dental benefits.
Covered Services
DIAGNOSTIC & PREVENTIVE PLAN PAYS
Diagnostic and Preventive Services – exams, cleanings, fluoride, and space maintainers 100%
Emergency Palliative Treatment – to temporarily relieve pain 100%
Sealants – to prevent decay of permanent teeth 100%
Brush Biopsy – to detect oral cancer 100%
Radiographs – X-rays 100%
BASIC SERVICES
Minor Restorative Services – fillings and crown repair 50%
Endodontic Services – root canals 50%
Periodontic Services – to treat gum disease 50%
Oral Surgery Services – extractions and dental surgery 50%
Major Restorative Services – crowns 50%
Other Basic Services – misc. services 50%
Relines and Repairs – to bridges, implants, and dentures 50%
MAJOR SERVICES
Prosthodontic Services – bridges, implants, and dentures 50%
ORTHODONTIC SERVICES
Orthodontic Services – braces 50%
Orthodontic Age Limit Dependent Children to the
end of the month of age 19
Return to the Table of Contents Gray Benefits 16
