What’s Covered
With two plan options available, you can choose the coverage that best meets your individual needs. Carefully review the benefit summary chart to determine which plan is right for you.
| Plan A | Plan B | |||
|---|---|---|---|---|
| *Delta Dental’s payment under this plan is limited to the applicable percentage of the lesser of: a) your dentist’s actual charges; or b) the Delta Dental DPOSM Maximum Plan Allowance (the highest amount that Delta Dental will pay to a Delta Dental DPO dentist where you received the services). You will be required to pay the balance of the dentist’s fee not paid by Delta Dental. When receiving treatment from a Delta Dental Premier® (Premier) dentist, you may be required to pay any cost above the Delta Dental DPO Maximum Plan Allowance, up to your dentist’s Premier Maximum Plan Allowance. When receiving treatment from a Non-Delta Dental Dentist, there is no limit regarding their fees. | ||||
| Delta Pays* | Member Pays | Delta Pays* | Member Pays | |
| Benefits in Year 1 | ||||
| Diagnostic and preventive (includes exams, X-rays and cleanings). NOTE: In Plan A, no deductible required for diagnostic or preventive services. In Plan B, Calendar Year Deductible applies. | 100% | 0% | 80% | 20% |
| Periodontal maintenance cleanings (gum cleanings) | 80% | 20% | 50% | 50% |
| Denture repairs | 80% | 20% | 50% | 50% |
| Restorations (fillings) | 50% | 50% | 50% | 50% |
| Oral surgery | 50% | 50% | 50% | 50% |
| Endodontics (root canals) | 50% | 50% | 50% | 50% |
| Additional Benefits After One Year of Continuous Enrollment | ||||
| Crown and cast restorations | 50% | 50% | 50% | 50% |
| Prosthodontics (dentures) | 50% | 50% | 50% | 50% |
| Temporomandibular Joint Dysfunction (TMJ) | 50% | 50% | 50% | 50% |
| Additional Benefits With Annual Rate Payment | ||||
| Dental Accident ($1,000 lifetime maximum) | 100% | 0% | Not a benefit in Plan B | |
| Deductibles and Maximums per Enrollee | ||||
| Calendar Year Deductible | $100 | $50 | ||
| Calendar Year Maximum Benefit | $1,500 | $1,000 | ||
| Temporomandibular Joint Dysfunction — Lifetime Maximum | $300 | $300 | ||
This is only a summary of the benefits available with the AARP Dental Insurance Plan. Please view the Certificate of Coverage/Benefit Handbook for a complete description. Also, you can view the plan's Limitations and Exclusions.
90-TX-WEB-003 01/09