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
UNIVERSITY CHOICE
Open access*
100% coverage After $50 annual deductible, 80% coverage After $50 annual deductible, 50% coverage Emergency dental services provided same as eligible dental services 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

* University Choice: When you use Delta network dentists, the deductible will be waived and your out-of-pocket cost will be reduced.

 

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, University Choice, 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

    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.