2019 Delta Dental Individual Plans
Delta Dental offers individual dental plans on the Iowa Health Insurance Marketplace at HealthCare.gov. The Marketplace is designed to help consumers apply for financial assistance, buy coverage and enroll.
Understanding how the Affordable Care Act (ACA or health care reform) has changed benefits will help you select a dental plan that best fits your needs.
View the 2019 brochure.
1. Delta Dental Plus Plans include the Pediatric Dental Essential Health Benefit.
Health plans sold to individuals must offer the ACA’s 10 defined essential health benefits (EHBs), one of which is pediatric dental care.
Children’s benefits must include:
- Coverage to age 19 (Delta Dental extends this benefit to age 21)
- No annual or lifetime benefit maximum
- Out-of-pocket limits of $350 per child or $700 for all children on the policy when seeing an in-network dentist
- Medically necessary orthodontia
Every Delta Dental of Iowa Plus plan meets or exceeds the pediatric requirements as defined by the ACA.
2. Your children may qualify for financial assistance.
Children (up to age 19) may be eligible to receive financial assistance for their dental insurance through the government’s Advanced Premium Tax Credits (APTCs). To determine eligibility, visit HealthCare.gov.
To receive financial assistance, you must enroll through the Iowa Health Insurance Marketplace at HealthCare.gov during the open enrollment period (November 1, 2017 – January 15, 2018). If you need assistance enrolling through the Marketplace, contact the State’s insurance navigator by going to HealthCare.gov or contact your local health insurance agent.
3. You can choose from three plans – Platinum, Preferred or Preventive
- Platinum Plus – our richest benefits with a $2,000 annual benefit maximum. This plan covers check-ups, cleanings, X-rays, cavity repair, implants, and major services. There are waiting periods for adults for some services.
- Preferred Plus – our most popular plan with a $1,000 annual benefit maximum. This plan covers check-ups, cleanings, X-rays, cavity repair, implants, and major services. There are waiting periods for adults for some services.
- Preventive Plus – for adults this plan covers care for check-ups, cleanings, X-rays, and cavity repair. This plan excludes coverage for implants, oral surgery, extractions and major services for adults. Children will receive benefits for check-ups, cleanings, X-rays, cavity repair, implants, and major services.
4. Get the richest benefits when you see a Delta Dental dentist.
With Delta Dental, you can see any dentist you choose, but benefits and out-of-pocket expenses vary depending on the network dentist you see:
- Delta Dental PPOSM Network – Richest benefits, lower out-of-pocket costs and access to 40 percent of Iowa dentists and 40 percent of the dentists nationwide.1
- Delta Dental Premier® Network – Richer benefits, reduced benefits and access to 90 percent of Iowa dentists and 75 percent of dentists nationwide.1
- Out-of-Network Dentists – Allows you to see an out-of-network dentist at higher costs and reduced benefits.
5. Per-Person Pricing
Benefits for adults and children are now different. As a result, Delta Dental uses per-person pricing for adults and children to give families the flexibility to choose only the benefits they can use. Each adult age 21 and older is charged a separate adult rate. Each child up to the age of 21 is charged a separate child rate. After paying to insure three children (up to the age of 21), any additional children up to the age of 21 are included on your policy at no additional cost to you, in accordance with the law.
Rates are the same whether you buy using the Health Insurance Marketplace or direct through your local health insurance agent or Delta Dental. Payment options include: