Compare dental plans
There are three PEBB Program dental plans to choose from — two managed care plans and one preferred-provider plan. Make sure you check with the plan to see if the dental provider you want is in the plan’s network.
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How do dental benefits compare?
Before you enroll in one of our dental plans, use the tables below to help you decide. For information on specific benefits and exclusions, refer to the dental plan’s certificate of coverage or contact the plan directly. If anything in these tables conflicts with the plan's COC, the COC takes precedence. All dental plans include a nonduplication of benefits clause, which applies when you have dental coverage under more than one account.Â
The tables below display 2023 benefits and costs.Â
Annual costs
| Â |
Uniform Dental Plan (UDP) (Group 3000 Delta Dental PPO) |
DeltaCare (Group 3100) |
Willamette Dental Group (Group WA82) |
|---|---|---|---|
| Deductible | You pay $50/person, $150/family | None | None |
| Plan maximum (see specific benefit maximums below) |
You pay amounts over $1,750 | None | None |
Services
| Â | Uniform Dental Plan (UDP) Preferred provider plan |
DeltaCare Managed-care plan |
Willamette Dental Group Managed-care plan |
|---|---|---|---|
| Â | You pay after deductible | You pay | You pay |
| Crowns | 50% PPO and out-of-state;Â 60% non-PPO |
$100 to $175 | $100 to $175 |
| Dentures | 50% PPO and out-of-state; 60% non-PPO |
$140 for complete upper or lower | $140 for complete upper or lower |
| Fillings | 20% PPO and out-of-state; 30% non-PPO |
30% of costs, then any amount after plan has paid $1,000 per year, then any amount over $5,000 in member's lifetime | Any amount after plan has paid $1,000 per year, then any amount over $5,000 in member's lifetime. |
| Nonsurgical TMJ | 30% of costs until plan has paid $500, then any amount over $500 in member's lifetime | 30% of costs, then any amount after plan has paid $1,000 per year, then any amount over $5,000 in member's lifetime | Any amount over $1,000 per year and $5,000 in member's lifetime |
| Oral surgery | 20% PPO and out-of-state; 30% non-PPO |
$10 to $50 to extract a tooth | $10 to $50 to extract a tooth |
| Orthodontia | 50% of costs until plan has paid $1,750, then any amount over $1,750 in member's lifetime (deductible doesn't apply) | Up to $1,500 copay per case | Up to $1,500 copay per case |
| Orthognathic surgery | 30% of costs until plan has paid $5,000, then any amount over $5,000 in member's lifetime | 30% of costs until plan has paid $5,000, then any amount over $5,000 in member's lifetime | 30% of costs until plan has paid $5,000, then any amount over $5,000 in member's lifetime |
| Periodontic services (treatment of gum disease) | 20% PPO and out-of-state; 30% non-PPO |
$15 to $100 | $15 to $100 |
| Preventive services | $0 (deductible doesn't apply) | $0 | $0 |
| Root canals (endodontics) | 20% PPO and out-of-state; 30% non-PPO |
$100 to $150 | $100 to $150 |
How do DeltaCare and Willamette Dental Group plans work?
DeltaCare and Willamette Dental Group are managed-care plans. You must select and receive care from a primary care dental provider in that plan’s network. If you choose one of these plans and seek services from a dentist not in the plan's network, the plan will not pay your dental claims. Before enrolling, call the plan to make sure your dentist is in the plan's network.
Neither plan has an annual deductible. You don’t need to track how much you have paid out-of-pocket before the plan begins covering benefits. You pay a set amount (copay) when you receive dental services. Neither plan has an annual maximum that they pay for covered benefits (some specific exceptions apply).
Referrals are required from your primary care dental provider to see a specialist. You may change providers in your plan’s network at any time.
How does Uniform Dental Plan (UDP) work?
UDP is a preferred-provider organization (PPO) plan. You can choose any dental provider, and change providers at any time. When you see a network provider, your out-of-pocket expenses are generally lower than if you chose a provider who is not part of this network. Under UDP, you pay a percentage of the plan’s allowed amount (coinsurance) for dental services after you have met the annual deductible. UDP pays up to an annual maximum of $1,750 for covered benefits for each enrolled family member, including preventive visits.
What providers can I see?
DeltaCare
You may only see providers in the DeltaCare (Group 3100) network. You'll have a primary care provider who oversees your care, and authorizes specialist referrals. If the provider you select is not in DeltaCare's Group 3100 network, you will be responsible for the costs.
Uniform Dental Plan
You may see any dental provider, but you'll usually pay less out-of-pocket if you go to a provider in the Delta Dental PPO Group 3000 network.
Willamette Dental Group
You may only see providers in the Willamette Dental Group network. You'll have a primary care provider who oversees your care, and authorizes specialist referrals.
What if I see an out-of-network provider?
DeltaCare
You'll be responsible for the costs.
Uniform Dental Plan
You'll be responsible for having your provider complete and sign a claim form.
Willamette Dental Group
You'll be responsible for the costs.
Preauthorization criteria
Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that your plan will pay for those services, supplies, or drugs.
Delta Dental of Washington (for DeltaCare and Uniform Dental Plan)
These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
Contact
DeltaCare
Online: DeltaCare for PEBB members
Phone: 1-800-650-1583
Uniform Dental Plan (UDP)
Online: Uniform Dental Plan for PEBB members
Phone: 1-800-537-3406
Willamette Dental Group
Online: Willamette Dental Group for PEBB members
Phone: 1-855-433-6825