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Oregon Dental Insurance > ODS Health Plans of Oregon > Premier Benefits


ODS Dental Plans

Delta Dental Premier Dental Plan Benefits

Plan year maximum, per member
First year benefit maximum
$750
Second year benefit maximum
$1,000
Third year benefit maximum
$1,250
Plan year deductible, per member $50
Service Benefit
Class 1
    Examinations/x-rays (routine exam & bitewing x-rays once every six months)
    Prophylaxis (cleanings once every six months)
    Fissure sealants
    Fluoride
Premier
Network
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 & certain minor surgical procedures)
    Endodontic (pulp therapy and root canal filling)
    Periodontics (treatment of tissues supporting the teeth)

    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%

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


 

 

 
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