Compare Your Options with Delta Dental

The following chart depicts the three plans offered to you under the Delta Dental Veterans Affairs Dental Insurance Program. When treatment is provided in-network by a Delta Dental PPO (DPO in Texas) network dentist your cost shares will be substantially lower. Your total out-of-pocket costs will increase when your care is provided by an out-of-network dentist. If you’re currently seeing a network dentist, you’re already saving! If not, or you’re unsure check the Dentist Directory to find a network dentist near you.

Plan Summary and Comparison
Plan Summary of Benefits Network Percentage
Service Category Standard Enhanced Comprehensive
In Network Out of Network In Network Out of Network In Network Out of Network
Year 1+ Year 1 Year 2+ Year 1 Year 2+ Year 1 Year 2+ Year 1 Year 2+
Diagnostic1 100% 80% 100% 100% 80% 80% 100% 100% 80% 80%
Preventive1 100% 80% 100% 100% 80% 80% 100% 100% 80% 80%
Basic Restorative 50% 30% 50% 50% 30% 30% 60% 60% 40% 40%
Major Restorative2 NAB NAB NAB NAB NAB NAB NAB 50% NAB 30%
Endodontics2 NAB NAB NAB 50% NAB 30% NAB 50% NAB 30%
Periodontics2 NAB NAB NAB 50% NAB 30% NAB 50% NAB 30%
Oral Surgery2, 3 50% 30% 50% 50% 30% 30% 50%3 50% 30% 30%
Prosthodontics2 NAB NAB NAB NAB NAB NAB NAB 50% NAB 30%
General Services NAB NAB NAB NAB NAB NAB 50% 50% 30% 30%
Orthodontics NAB NAB NAB NAB NAB NAB NAB NAB NAB NAB
Deductible $50 $50 $501 $501 $501 $501 $0 $0 $501 $501
Annual Maximum $500 $500 $1,000 $1,000 $1,000 $1,000 $1,500 $1,500 $1,500 $1,500

NAB = Not a Benefit

1The deductible is waived for diagnostic and preventive services; under the Enhanced plan. Under the Comprehensive plan the deductible is waived for diagnostic and preventive services provided out-of-network, and there is no deductible for any services provided in-network.

2Enhanced Plan: The waiting period is twelve (12) months for endodontics and periodontics. Comprehensive Plan: The waiting period is 12 months for major restorative, endodontics, periodontics, oral surgery,3 and prosthodontics.

3Simple extractions (procedure codes D7111 and D7140) are the only oral surgery services covered under the Standard and Enhanced plan, and the only services covered in the first 12 months under the Comprehensive plan.

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