Dental

Boone Health offers two dental options, High and Low, administered by Delta Dental of Missouri.

Both dental options provide access to the Delta Dental Premier network, featuring 80 percent of dental care providers nationwide and access to the Delta Dental PPO (preferred provider organization) network, which includes nearly 50 percent of all dentists nationwide.

Both High and Low options cover in-network preventive services (two dental cleanings per year) with no deductible. Both options cover basic care and major care, with dental plan participants paying more for these services under the Low option. Orthodontia is covered only in the High option.

www.DeltaDentalMO.com

Delta Dental Customer Service - 800.335.8266

Dental Coverage Chart

High Low
PPO Network Premier Network Non-Network PPO Network Premier Network Non-Network
Annual Deductible
Per Individual $50 $50 $50 $75 $75 $75
Per Family $100 No Limit No Limit $150 No Limit No Limit
Preventive Care 0%; no deductible 0%; no deductible 20%; no deductible 0%; no deductible 0%; no deductible 40%; no deductible
Basic Care 20%; after deductible 40%; after deductible 40%; after deductible 30%; after deductible 40%; after deductible 40%; after deductible
Major Care 40%; after deductible 60%; after deductible 60%; after deductible 50%; after deductible 60%; after deductible 60%; after deductible
Annual Maximum Benefit $2,000 $1,500 $1,500 $1,000 $750 $750
Orthodontia Benefit
Services 40%; after deductible 60%; after deductible 60%; after deductible No coverage No coverage No coverage
Lifetime Maximum $2,000 $1,500 $1,500

Employee Cost for Dental Coverage

The costs below are pre-tax, per-pay-period deductions, based on 26 pay periods a year.

Full-time & Part-time
HIGH
Employee Only $4.80
Employee + Children $19.18
Employee + Spouse $17.79
Employee + Family $23.10
LOW
Employee Only $3.06
Employee + Children $11.05
Employee + Spouse $11.14
Employee + Family $13.04

Find a Dentist

With the Delta Dental “Find a Provider” search tool you can search for a dentist in your area. You also can use the tool to determine if your current dentist is within Delta Dental’s networks.

Dental plan participants who discover that their current dentist is not within Delta Dental’s Premier or PPO networks, might want to ask their non-participating dentist to contact Delta Dental or call 800.335.8266 to become a participating provider, since the cost of network dental services are significantly less than those received out of network.

Mobile App

The Delta Dental mobile app delivers fast access to dentist search, claims, coverage, cost estimates, ID card information and more. Instructions to download the mobile app please visit https://www.deltadentalmo.com/Members/MobileApp

ID Cards / Contact Delta Dental

Delta Dental issues your dental ID card. If you do not have your ID card, your provider can call Delta Dental to verify your eligibility and benefits. For more information go to the Delta Dental website or call toll-free 800.335.8266.

Delta Dental Network Benefits - Boone Health High Plan

Delta Dental Network Benefits - Boone Health Low Plan