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Clear Plan from Delta Dental
Policy service is provided by Delta Dental of Wisconsin, Inc. located at 2801 Hoover Road, P.O. Box 103, Stevens Point, WI 54481‐0103 ... 5.0 CHOOSING A DENTIST 18 6.0 POLICY COVERAGE TERMS 20 ... You can get Delta Dental Participating Dentist and Delta Dental PPO ℠ …
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Clear Plan Insurance Policy from Delta Dental. A new way ...
www2.deltadentalcoversme.comTissue graft procedures and removal of excess tissue. $740 . Bone surgery once per area every three years. $115 . Non‐surgical extractions. $230 . Surgical extractions. $115 . General anesthesia in conjunction with covered surgical procedures, once per treatment.
Schedule of Benefits (Who Pays What)
www2.deltadentalcoversme.comIf you see a provider that is not in the Delta Dental Premier or Delta Dental PPO networks, you will be responsible for all charges incurred. Find a listing of more than 1,000 Delta Dental PPO provider locations in Colorado and hundreds of thousands of Delta Dental network providers nationwide at www.DeltaDentalCoversMe.com, or call 888-899-3734.
Delta Dental PPO Schedule of Benefits CLASSIC PLAN
www2.deltadentalcoversme.comUnder this Delta Dental PPO plan, you may visit any Provider of your choice. There are three levels of Providers to choose from who are located nationwide: PPO Participating Provider. Advantages of seeing a PPO Provider include: • Payment is based upon the PPO Provider's Allowable fee, or the fee actually charged, whichever is less.
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