Dental Plan

The following chart outlines the dental benefits offered by Oklahoma City Community College. You will pay the least out-of-pocket if you visit a PPO network provider and the most if you visit an out-of-network provider.

 

 

DENTAL:

Service	PPO	Premier	Out-of-Network
Annual Deductible Individual Family	$50 $150	$50 $150	$50 $150
Class I Services Exams, cleanings, x-rays	100%	100%	90%
Class II Services Endodontics, periodontics, oral surgery	90% after deductible	80% after deductible	70% after deductible
Class III Services Crowns, dentures, and implants	60% after deductible	50% after deductible	40% after deductible
Class IV: Orthodontic Services	Not Covered	Not Covered	Not Covered
Annual Benefit Maximum *Routine cleanings are not applied to annual maximum	$1,000 per participant	$1,000 per participant	$1,000 per participant

DENTAL BUY-UP:

Service	PPO	Premier	Out-of-Network
Annual Deductible Individual Family	$50 $150	$50 $150	$50 $150
Class I Services Exams, cleanings, x-rays	100%	100%	90%
Class II Services Endodontics, periodontics, oral surgery	90% after deductible	80% after deductible	70% after deductible
Class III Services Crowns, dentures, and implants	60% after deductible	50% after deductible	40% after deductible
Class IV: Orthodontic Services	Not Covered	Not Covered	Not Covered
Annual Benefit Maximum *Routine cleanings are not applied to annual maximum	$2,000 per participant	$2,000 per participant	$2,000 per participant

Using Your Dental Benefits

To locate a network provider who's right for you, visit www.deltadentalok.org.

At your appointment, tell the provider you have Delta Dental of Oklahoma. There is no ID card necessary.

If you'd like a card as a reference, you can print one by logging into your member portal at www.deltadentalok.org.