Our traditional dental insurance plans feature:
Traditional Dental Plans
-
Affordable monthly premiums starting at $20
-
Free Until ThreeTM - No charge for kids under 3
-
Up to $2,000 annual maximum
Which dental plan is right for you?
Let's help you get the best dental plan!
Saguaro Plan-763
$27
.45 per person, per month
per person, per month
Mesquite Plan-762 | Delta Dental PPO™
Covered Services
You Pay
Delta Dental Pays
Notes
Annual Maximum
Per person, per benefit year
$2,000
Annual maximum benefit amount represents a combination of all networks & is not cumulative.
Deductible
Per person, per benefit year
$50
Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative.
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
0%
100%
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
20%
80%
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to crowns/dentures/bridges
50%
50%
6-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
50%
50%
9-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage.
Annual Maximum
Per person, per benefit year
| You Pay | |
| Delta Dental Pays | $2,000 |
| Notes | Annual maximum benefit amount represents a combination of all networks & is not cumulative. |
Deductible
Per person, per benefit year
| You Pay | $50 |
| Delta Dental Pays | |
| Notes | Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative. |
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
| You Pay | 0% |
| Delta Dental Pays | 100% |
| Notes |
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
| You Pay | 20% |
| Delta Dental Pays | 80% |
| Notes |
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to crowns/dentures/bridges
| You Pay | 50% |
| Delta Dental Pays | 50% |
| Notes | 6-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage |
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
| You Pay | 50% |
| Delta Dental Pays | 50% |
| Notes | 9-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage. |
Saguaro Plan-763 | Delta Dental PPO™
Covered Services
You Pay
Delta Dental Pays
Notes
Annual Maxium
Per person, per benefit year
$1,500
Annual maximum benefit amount represents a combination of all networks & is not cumulative.
Deductible
Per person, per benefit year
$50
Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative.
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
0%
100%
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
40%
60%
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to dentures/crowns/bridges
40%
60%
6-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage.
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
60%
40%
9-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage.
Annual Maxium
Per person, per benefit year
| You Pay | |
| Delta Dental Pays | $1,500 |
| Notes | Annual maximum benefit amount represents a combination of all networks & is not cumulative. |
Deductible
Per person, per benefit year
| You Pay | $50 |
| Delta Dental Pays | |
| Notes | Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative. |
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
| You Pay | 0% |
| Delta Dental Pays | 100% |
| Notes |
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
| You Pay | 40% |
| Delta Dental Pays | 60% |
| Notes |
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to dentures/crowns/bridges
| You Pay | 40% |
| Delta Dental Pays | 60% |
| Notes | 6-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage. |
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
| You Pay | 60% |
| Delta Dental Pays | 40% |
| Notes | 9-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage. |
Agave Plan-764 | Delta Dental PPO™
Covered Services
You Pay
Delta Dental Pays
Notes
Annual Maximum
Per person, per benefit year
$1,000
Annual maximum benefit amount represents a combination of all networks & is not cumulative.
Deductible
Per person, per benefit year
$50
Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative.
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
10%
90%
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
60%
40%
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to dentures/crowns/bridges
70%
30%
6-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage.
Type 3B: Major Services
Implants, crowns complete/partial dentures & bridges
70%
30%
9-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage.
Annual Maximum
Per person, per benefit year
| You Pay | |
| Delta Dental Pays | $1,000 |
| Notes | Annual maximum benefit amount represents a combination of all networks & is not cumulative. |
Deductible
Per person, per benefit year
| You Pay | $50 |
| Delta Dental Pays | |
| Notes | Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative. |
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
| You Pay | 10% |
| Delta Dental Pays | 90% |
| Notes |
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
| You Pay | 60% |
| Delta Dental Pays | 40% |
| Notes |
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to dentures/crowns/bridges
| You Pay | 70% |
| Delta Dental Pays | 30% |
| Notes | 6-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage. |
Type 3B: Major Services
Implants, crowns complete/partial dentures & bridges
| You Pay | 70% |
| Delta Dental Pays | 30% |
| Notes | 9-month waiting period. May be waived if you were covered under a prior PPO/Indemnity dental plan with no more than a 63-day gap in coverage. |
Cholla Plan-765 | Delta Dental PPO™
Covered Services
You Pay
Delta Dental Pays
Notes
Annual Maximum
Per person, per benefit year
Unlimited
Annual maximum benefit amount represents a combination of all networks & is not cumulative.
Deductible
Per person, per benefit year
$25
Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative.
Type 1: Preventive Services
Exams, cleanings, fluoride & sealants
0%
100%
Space maintainers are not covered services.
Type 2: Basic Services
X-rays & periodontal maintenance
50%
50%
Simple extractions & fillings are not covered services.
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to crowns/dentures/bridges
Not Covered
Not Covered
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
Not Covered
Not Covered
Annual Maximum
Per person, per benefit year
| You Pay | |
| Delta Dental Pays | Unlimited |
| Notes | Annual maximum benefit amount represents a combination of all networks & is not cumulative. |
Deductible
Per person, per benefit year
| You Pay | $25 |
| Delta Dental Pays | |
| Notes | Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative. |
Type 1: Preventive Services
Exams, cleanings, fluoride & sealants
| You Pay | 0% |
| Delta Dental Pays | 100% |
| Notes | Space maintainers are not covered services. |
Type 2: Basic Services
X-rays & periodontal maintenance
| You Pay | 50% |
| Delta Dental Pays | 50% |
| Notes | Simple extractions & fillings are not covered services. |
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to crowns/dentures/bridges
| You Pay | Not Covered |
| Delta Dental Pays | Not Covered |
| Notes |
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
| You Pay | Not Covered |
| Delta Dental Pays | Not Covered |
| Notes |
Looking for something different? Perhaps our incentive-based individual dental plans are a better match for your needs. (Scroll up to the tabs at the top of the page to check them out.)
Our incentive dental plans feature:
-
No waiting periods
-
Free Until ThreeTM - No charge for kids under 3
-
Up to $2,000 annual maximum
Which dental plan is right for you?
Let's help you get the best dental plan!
Copper Plan-766 | Delta Dental PPO™
Covered Services
In Year 1, You Pay
In Year 2, You Pay
In Year 3+, You Pay
Notes
Annual Maximum
Per person, per benefit year
$1,500*
$1,750*
$2,000*
*This is the maximum amount Delta Dental will pay toward covered dental services for each person on the plan. You may pay more/less. Annual maximum benefit amount represents a combination of all networks & is not cumulative.
Deductible
Per person, per benefit year
$50
$50
$50
Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative.
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
0%
0%
0%
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
60%
40%
20%
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to crowns/dentures/bridges
70%
60%
50%
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
70%
60%
50%
Annual Maximum
Per person, per benefit year
| In Year 1, You Pay | $1,500* |
| In Year 2, You Pay | $1,750* |
| In Year 3+, You Pay | $2,000* |
| Notes | *This is the maximum amount Delta Dental will pay toward covered dental services for each person on the plan. You may pay more/less. Annual maximum benefit amount represents a combination of all networks & is not cumulative. |
Deductible
Per person, per benefit year
| In Year 1, You Pay | $50 |
| In Year 2, You Pay | $50 |
| In Year 3+, You Pay | $50 |
| Notes | Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative. |
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
| In Year 1, You Pay | 0% |
| In Year 2, You Pay | 0% |
| In Year 3+, You Pay | 0% |
| Notes |
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
| In Year 1, You Pay | 60% |
| In Year 2, You Pay | 40% |
| In Year 3+, You Pay | 20% |
| Notes |
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to crowns/dentures/bridges
| In Year 1, You Pay | 70% |
| In Year 2, You Pay | 60% |
| In Year 3+, You Pay | 50% |
| Notes |
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
| In Year 1, You Pay | 70% |
| In Year 2, You Pay | 60% |
| In Year 3+, You Pay | 50% |
| Notes |
Turquoise Plan-767 | Delta Dental PPO™
Covered Services
In Year 1, You Pay
In Year 2, You Pay
In Year 3+, You Pay
Notes
Annual Maxium
Per person, per benefit year
$1,000*
$1,250*
$1,500*
*This is the maximum amount Delta Dental will pay toward covered dental services for each person on the plan. You may pay more/less. Annual maximum benefit amount represents a combination of all networks & is not cumulative.
Deductible
Per person, per benefit year
$50
$50
$50
Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative.
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
20%
10%
0%
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
70%
60%
50%
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to dentures/crowns/bridges
70%
60%
50%
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
70%
60%
50%
Annual Maxium
Per person, per benefit year
| In Year 1, You Pay | $1,000* |
| In Year 2, You Pay | $1,250* |
| In Year 3+, You Pay | $1,500* |
| Notes | *This is the maximum amount Delta Dental will pay toward covered dental services for each person on the plan. You may pay more/less. Annual maximum benefit amount represents a combination of all networks & is not cumulative. |
Deductible
Per person, per benefit year
| In Year 1, You Pay | $50 |
| In Year 2, You Pay | $50 |
| In Year 3+, You Pay | $50 |
| Notes | Deductible applies to all services. Deductible amount represents a combination of all networks & is not cumulative. |
Type 1: Preventive Services
Exams, cleanings, fluoride, space maintainers & sealants
| In Year 1, You Pay | 20% |
| In Year 2, You Pay | 10% |
| In Year 3+, You Pay | 0% |
| Notes |
Type 2: Basic Services
X-rays, periodontal maintenance, simple extractions & composite fillings
| In Year 1, You Pay | 70% |
| In Year 2, You Pay | 60% |
| In Year 3+, You Pay | 50% |
| Notes |
Type 3A: Major Services
Gum disease treatment, root canals, surgical extractions, general anesthesia, denture relines/rebases/adjustments & repairs to dentures/crowns/bridges
| In Year 1, You Pay | 70% |
| In Year 2, You Pay | 60% |
| In Year 3+, You Pay | 50% |
| Notes |
Type 3B: Major Services
Implants, crowns, complete/partial dentures & bridges
| In Year 1, You Pay | 70% |
| In Year 2, You Pay | 60% |
| In Year 3+, You Pay | 50% |
| Notes |
Looking for something different? Perhaps our traditional individual dental plans are a better match for your needs. (Scroll up to the tabs at the top of the page to check them out.)
Want savings on vision coverage?
Add DeltaVision® to your dental plan!
Vision Plan-100 | EyeMed Advantage Network
Covered Services
You Pay
Exam with Dialation (as necessary)
$10 copay
Fundus Photography Benefit
Up to $39
Standard Contact Lens Fit & Follow-up
Up to $40
Premium Contact Lens Fit & Follow-up
10% off retail price
Frames
$0 copay; $130 allowance, 20% off balance over $130
Standard Plastic Lens: Single Vision, Bifocal, Trifocal or Lenticular
$10 copay
Standard Plastic Lens: Standard Progressive
$70 copay
Standard Plastic Lens: Premium Progressive
$70 copay, 80% of charge less $120 allowance
Lens Option: UV Treatment
$12
Lens Option: Tint (Solid & Gradient)
$12
Lens Option: Standard Plastic Scratch Coating
$12
Lens Option: Standard Polycarbonate - Adults & Kids
$35
Lens Option: Standard Anti-Reflective Coating
$40
Lens Option: Premium Anti-Reflective
80% of charge
Lens Option: Polarized
30% off retail price
Lens Option: Other Add-ons
30% off retail price
Contact Lenses: Conventional
Materials only
$0 copay, $130 allowance, 15% off balance over $130
Contact Lenses: Disposable
Materials Only
$0 copay, $130 allowance, plus balance over $130
Contact Lenses: Medically Necessary
Materials only
$0 copay, paid-in-full
Laser Vision Correction
Lasik or PRK from U.S. Laser Network
15% off retail price or 5% off promotional price
Frequency: Exam
Once every 12 months
Frequency: Lenses or Contact Lenses
Once every 12 months
Frequency: Frame
Once every 12 months
Exam with Dialation (as necessary)
| You Pay | $10 copay |
Fundus Photography Benefit
| You Pay | Up to $39 |
Standard Contact Lens Fit & Follow-up
| You Pay | Up to $40 |
Premium Contact Lens Fit & Follow-up
| You Pay | 10% off retail price |
Frames
| You Pay | $0 copay; $130 allowance, 20% off balance over $130 |
Standard Plastic Lens: Single Vision, Bifocal, Trifocal or Lenticular
| You Pay | $10 copay |
Standard Plastic Lens: Standard Progressive
| You Pay | $70 copay |
Standard Plastic Lens: Premium Progressive
| You Pay | $70 copay, 80% of charge less $120 allowance |
Lens Option: UV Treatment
| You Pay | $12 |
Lens Option: Tint (Solid & Gradient)
| You Pay | $12 |
Lens Option: Standard Plastic Scratch Coating
| You Pay | $12 |
Lens Option: Standard Polycarbonate - Adults & Kids
| You Pay | $35 |
Lens Option: Standard Anti-Reflective Coating
| You Pay | $40 |
Lens Option: Premium Anti-Reflective
| You Pay | 80% of charge |
Lens Option: Polarized
| You Pay | 30% off retail price |
Lens Option: Other Add-ons
| You Pay | 30% off retail price |
Contact Lenses: Conventional
Materials only
| You Pay | $0 copay, $130 allowance, 15% off balance over $130 |
Contact Lenses: Disposable
Materials Only
| You Pay | $0 copay, $130 allowance, plus balance over $130 |
Contact Lenses: Medically Necessary
Materials only
| You Pay | $0 copay, paid-in-full |
Laser Vision Correction
Lasik or PRK from U.S. Laser Network
| You Pay | 15% off retail price or 5% off promotional price |
Frequency: Exam
| You Pay | Once every 12 months |
Frequency: Lenses or Contact Lenses
| You Pay | Once every 12 months |
Frequency: Frame
| You Pay | Once every 12 months |
Love what you see? Individual vision coverage is only available as an add-on to your individual dental policy and will be offered during the final steps of the enrollment process.
Choosing the Right Dental Plan for Your Family
Don't live in Arizona? Visit our national website if you're looking for individual dental insurance plans in another state.
1 2014 Delta Dental Oral Health & Well-Being Survey.
Disclaimers
Plan information provided as a summary only. For full coverage specifics on any of these plans, including frequencies and limitations, refer to the appropriate plan booklet.
Rates are subject to change and vary by plan. For the most current rates, visit smilepoweraz.com.
Primary subscriber must be 18+ to enroll an eligible dependent in via the Free Until Three feature. See plan booklet for more info.
These dental plans reimburse procedures based on the Delta Dental PPO fee. Premier and out-of-network dentist may bill you for charges above the allowed Delta Dental PPO fee. As a result, you may incur higher out-of-pocket costs when seeing a Premier or out-of-network dentist.
The granting of a waiver of any waiting periods is in the sole discretion of Delta Dental of Arizona.
This vision policy is underwritten by Arizona Dental Insurance Service, Inc. dba Delta Dental of Arizona. Policies are administered, at least in part, by First American Administrators, Inc. and Renaissance Life & Health Insurance Company of America Inc. Certain network administration services are provided through EyeMed Vision Care, LLC.
