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The UT SELECT Dental Plus Plan provides all of the benefits of the UT SELECT Dental Plan, plus increased benefits and plan limit maximums. Just like the UT SELECT plan, you may visit any dental provider, although you may pay less out of pocket if you choose a Delta Dental network (DPO or Premier) dentist.
| Benefits and Covered Services1 | UT SELECT Dental Plus1 2 |
|---|---|
| Deductible | No deductible with UT SELECT Denntal Plus |
| Maximums (each plan year) | $3,000 |
| Orthodontic Maximums (Lifetime) | $3,000 |
| Diagnostic & Preventive Services (D&P) Exams, cleanings, x-rays, sealants | 100% |
| Basic Services Fillings, stainless steel crowns | 100% |
| Endodontics (root canals) Covered Under Basic Services | 100% |
| Periodontics (periodontal scaling, Root planning, and treatment of gum disease. Covered Under Basic Services | 100% |
| Oral Surgery Covered Under Basic Services | 100% |
| Major Services Crowns, inlays, onlays and cast restorations, bridges and dentures | 80% |
| Orthodontic Benefits Adults and dependent children | 80% |
1 Limitations may apply for some benefits; some services may be excluded from your plan. Reimbursement is based on Delta Dental contract allowances and not necessarily each dentist’s actual fees.
2 Fees are based on DPO contracted fees for DPO dentists, Premier contracted fees for Premier dentists, and Premier contracted fees for non-Delta Dental dentists.
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