Dental Plan Availability & Comparison


Dental Plan Comparison

For all of the dental plans, the annual maximum is $1,800 for all benefits per person per contract year. You can find the detail of what is covered in each category below the chart.

Plan Diagnostic and
Preventive Care
Basic Resorative Care Major Resorative Care Emergency Services Orthodontics
DELTA DENTAL PREMIER
In-network
100% coverage 80% coverage 50% coverage Emergency dental services provided same as eligible dental services 80% coverage
DELTA DENTAL PREMIER
Out-of-network
50% coverage After $125 annual deductible, 50% coverage No coverage After $125 annual deductible, emergency dental services provided same as eligible out-of-network services 50% coverage
DELTA DENTAL PPO
In-network coverage only
100% coverage 80% coverage 50% coverage In-network services provided same as any service; out-of-network services apply $50 deductible then same as any in-network service 80% coverage
UPLAN HEALTHPARTNERS DENTAL CHOICE
In-network
100% coverage 80% coverage 50% coverage Emergency dental services provided same as eligible dental services 80% coverage
UPLAN HEALTHPARTNERS DENTAL CHOICE
Out-of network
50% coverage After $125 annual deductible, 50% coverage No coverage After $125 annual deductible, emergency dental services provided same as eligible out-of-network services 50% coverage
UPLAN HEALTHPARTNERS DENTAL
In-network coverage only
100% coverage 80% coverage 50% coverage In-network services provided same as any service; out-of-network services apply $50 deductible then same as any in-network service 80% coverage

 

What is Covered Under Each Type of Service?

Diagnostic and Preventive Care

    • Oral examinations and dental cleanings
      • Two oral exams and cleanings per person per calendar year
      • X-rays
      • Special periodontics care
      • Topical fluoride to age 19
      • Space maintainers

Basic Restorative Care

      • Fillings (customary restorative materials)
        • Plan coverage on back teeth based on composite (white) fillings: Delta Dental Premier and HealthPartners Dental Choice
        • Plan coverage on back teeth based on amalgam (silver) fillings: Delta Dental PPO and HealthPartners Dental
        • Plan coverage on front teeth based on composite (white) fillings: All Plans
      • Sealants to age 19
      • Extractions and other oral surgery
      • Periodontics (gum disease therapy)
      • Endodontics (root canal therapy)
      • Restorative crowns
      • Inlays & onlays, repair of crown

Major Restorative Care

      • Fixed or removable bridgework
      • Implants as alternative treatment
      • Full or partial dentures
      • Denture relines or rebases

Orthodontics Coverage

      • Limited to dependents up to age 19
      • Separate $2,800 lifetime maximum per covered dependent that does not start over if you change plans

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Dental: Plan Availability

Yes: Plan is available
No: Not available
Base Plan: Base Plan for this county

County HP Dental and Dental Choice Delta Dental PPO Delta Dental Premier
Aitkin Yes Yes Yes - Base Plan
Anoka Yes Yes - Base Plan Yes
Becker Yes Yes Yes - Base Plan
Beltrami Partial Yes Yes - Base Plan
Benton Yes Yes Yes - Base Plan
Big Stone Yes No Yes - Base Plan
Blue Earth Yes Yes Yes - Base Plan
Brown Yes Yes Yes - Base Plan
Carlton* Yes Yes - Base Plan Yes - Base Plan
Carver Yes Yes - Base Plan Yes
Cass Yes Yes Yes - Base Plan
Chippewa Yes Yes Yes - Base Plan
Chisago Yes Yes - Base Plan Yes
Clay Yes Yes Yes - Base Plan
Clearwater Yes Yes Yes - Base Plan
Cook Partial No Yes - Base Plan
Cottonwood Yes Yes Yes - Base Plan
Crow Wing Yes Yes Yes - Base Plan
Dakota Yes Yes - Base Plan Yes
Dodge Yes No Yes - Base Plan
Douglas Yes Yes Yes - Base Plan
Faribault Yes Yes Yes - Base Plan
Fillmore Yes Yes Yes - Base Plan
Freeborn Yes Yes Yes - Base Plan
Goodhue Yes Yes Yes - Base Plan
Grant Yes No Yes - Base Plan
Hennepin Yes Yes - Base Plan Yes
Houston Yes Yes Yes - Base Plan
Hubbard Yes Yes Yes - Base Plan
Isanti Yes Yes - Base Plan Yes
Itasca Yes Yes Yes - Base Plan
Jackson Yes Yes Yes - Base Plan
Kanabec Yes Yes - Base Plan Yes
Kandiyohi Yes Yes Yes - Base Plan
Kittson Partial Yes Yes - Base Plan
Koochiching Yes Yes Yes - Base Plan
Lac Qui Parle Yes Yes Yes - Base Plan
Lake Partial Yes - Base Plan Yes
Lake of the Woods Partial No Yes - Base Plan
Le Sueur Yes Yes Yes - Base Plan
Lincoln Yes No Yes - Base Plan
Lyon Yes Yes Yes - Base Plan
Mahnomen Yes Yes Yes - Base Plan
Marshall Yes No Yes - Base Plan
Martin Yes Yes Yes - Base Plan
McLeod Yes Yes - Base Plan Yes
Meeker Yes Yes Yes - Base Plan
Mille Lacs Yes Yes Yes - Base Plan
Morrison Yes Yes Yes - Base Plan
Mower Yes Yes Yes - Base Plan
Murray Yes No Yes - Base Plan
Nicollet Yes Yes Yes - Base Plan
Nobles Yes Yes Yes - Base Plan
Norman Yes No Yes - Base Plan
Olmstead Yes Yes Yes - Base Plan
Otter Tail Yes Yes Yes - Base Plan
Pennington Yes Yes Yes - Base Plan
Pine Yes Yes Yes - Base Plan
Pipestone Yes Yes Yes - Base Plan
Polk Yes Yes Yes - Base Plan
Pope Yes Yes Yes - Base Plan
Ramsey Yes Yes - Base Plan Yes
Red Lake Yes No Yes - Base Plan
Redwood Yes Yes Yes - Base Plan
Renville Yes Yes Yes - Base Plan
Rice Yes Yes Yes - Base Plan
Rock Yes Yes Yes - Base Plan
Roseau Yes No Yes - Base Plan
Scott Yes Yes - Base Plan Yes
Sherburne Yes Yes - Base Plan Yes
Sibley Yes Yes Yes - Base Plan
St. Louis Partial Yes - Base Plan Yes
Stearns Yes Yes Yes - Base Plan
Steele Yes Yes Yes - Base Plan
Stevens Yes Yes Yes - Base Plan
Swift Yes No Yes - Base Plan
Todd Yes Yes Yes - Base Plan
Traverse Yes Yes Yes - Base Plan
Wabasha Yes Yes Yes - Base Plan
Wadena Yes Yes Yes - Base Plan
Waseca Yes No Yes - Base Plan
Washington Yes Yes - Base Plan Yes
Watonwan Yes Yes Yes - Base Plan
Wilkin Yes Yes Yes - Base Plan
Winona Yes Yes Yes - Base Plan
Wright Yes Yes - Base Plan Yes
Yellow Medicine Yes Yes Yes - Base Plan

*Carlton Northern area: Delta Dental PPO. Carlton Southern area: Delta Dental Premier.

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