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| Individual Dental Plans | ||||||||||||||||||||||||||
Brokers can enroll their clients online for insured products from the Dental Dental of Arizona Individual and Family plans.
Select following for complete Individual and Family plan details and eligibility.
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| Coverage Options | Green | Blue | Purple | Orange | Yellow | |||||||||||||||||||||
| Annual Maximum (benefit year) |
$2000 | $1500 | $1000 | $1000 | $500 | |||||||||||||||||||||
| Deductible (benefit year) (per person, applies to all services) |
$50 | $50 | $75 | $100 | $25 | |||||||||||||||||||||
| Type 1 Preventative Services | 100% | 100% | 90% | 70% | 100% | |||||||||||||||||||||
| Exams (limited to 2 per person in benefit year)
Cleanings (limited to 2 per person in a benefit year) Fluoride Treatments (limited to 1 per person in a benefit period, under age 16) Space Maintainers (under age 14) Sealants (under age 15) |
Fluoride to age 18;
Sealants to age 19; Space Maintainers are not covered |
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| Type 2 Basic Services | 50% | 50% | 50% | 50% | 100% | |||||||||||||||||||||
| Bitewing X–rays (limited to 1 set per
person in a benefit year) X–rays (full mouth/ panoramic – limited to 1 per person in 60 months) Simple Extractions (Not covered on Yellow Plan) Fillings (Not covered on Yellow Plan) |
Extractions and fillings are not covered on the Yellow Plan. | |||||||||||||||||||||||||
| Type 3A Major Services - 12 month waiting period* | 50% | 50% | 40% | 30% | Not Covered | |||||||||||||||||||||
| Gum Disease Treatment Root Canals Surgical Extractions General Anesthesia Denture Relines and Rebases, Adjustments Repairs to Crowns, Dentures and Bridges |
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| Type 3B Major Services – 24 month waiting period* | 50% | 50% | 40% | 30% | Not Covered | |||||||||||||||||||||
| Special Restorative Crowns Complete and partial dentures Fixed Bridgework |
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| Monthly Premium | ||||||||||||||||||||||||||
| Individual Only | $44.32 | $41.72 | $30.53 | $25.20 | $18.71 | |||||||||||||||||||||
| Individual + 1 Dependent | $81.99 | $77.18 | $56.48 | $46.62 | $34.61 | |||||||||||||||||||||
| Individual + 2 or More Dependents | $125.43 | $118.07 | $86.40 | $71.32 | $60.81 | |||||||||||||||||||||
* If within the past 60 days you have been covered under a Delta Dental group plan, and had at least 12 months of continuous coverage under that plan, waiting periods may be waived. Dentists, employees and dependents of dental offices do not qualify for this plan. For additional benefit information and limitations, please refer to the benefit booklet.
