View Plans and Rates
Delta Dental has affordable dental and vision plan options available for you and your family. These plans make it easy to protect your health and your wallet. You can choose from two dental plans that cover a wide range of services you may need—from routine services like oral exams, cleanings and X-rays to more complex services like bridges, crowns and dentures. You can add vision coverage to any dental plan to help you and your family maintain healthy eyesight. Our dental and vision plans are available to all Arkansas residents, regardless of age, dental history or pre-existing conditions, and our family plans provide coverage for dependent children up until the age of 26. Are you ready to start protecting your smile and your vision? For more information about costs, details of coverage, or to enroll online, visit www.mysmilecoverage.com/AR.
WHAT'S COVERED?
Preventive and
Diagnostic
- Two routine exams per benefit period
- X-rays
- Two cleanings per benefit period
- Two fluoride applications for dependent children up to age 19
- Sealants for dependent children up to age 16
Basic Restorative Services
- Minor emergency treatment
- Fillings
- Simple extractions
- Space maintainers for dependent children up to age 14
Major Restorative Services
- Crowns
- Endodontics (root canals)
- Oral surgery
- Stainless steel crowns for dependent children up to age 16
- Dentures, bridges, partials
- Periodontics treatment (gum disease)
Dental Plans
| In-network Dental | Comprehensive | Preventive |
| Individual Deductible | $50 | $50 |
| Benefit-year Maximum | $1,000 | $500 |
| What the plan pays for after you have satisfied the deductible | ||
| Preventive & Diagnostic | 100% | 100% |
| Basic Restorative Services | 80% | Not Covered |
| Major Restorative Services | 50% | Not Covered |
| Waiting Periods* | ||
| Preventive & Diagnostic | None | None |
| Basic Restorative Services | 6 Months | Not Covered |
| Major Restorative Services | 12 Months | Not Covered |
| Monthly Premiums | ||
| Individual | $30.82 | $15.81 |
| Individual & Child(ren) | $63.96 | $30.38 |
| Individual & Spouse | $65.51 | $31.64 |
| Family | $97.13 | $41.38 |
| Out-of-network Benefits |
.
The benefit allowance for services of an out of network dentist will be reduced by 10 percent for eligible services as determined by Delta Dental of Arkansas after applying the applicable deductibles, co-payments and maximums. This means your out-of-pocket expense will be more if you choose an out-of-network dentist.
| *Waiting periods will be waived if: |
1. Your application is received within 31 days of the termination of your prior carrier
AND
2. You have had at least 6 months of continuous coverage in Basic Restorative Services
AND
3. You have had at least 12 months of continuous coverage in Major Restorative Services
To waive waiting periods, please submit a copy of your Certificate of Creditable Coverage verifying your previous dental coverage and a copy of your covered benefits.
Individual Dental Comprehensive Plan
Vision Plans
| In-network Vision | Covered | |
| Vision Exam | Every
12 months |
Covered in full after
$10 co-pay |
| Frames | Every
24 months |
Covered in full after $25 co-pay for any frame with a wholesale value up to $110. Frames from participating Walmart locations are covered up to a $52 retail value. |
| Lenses | Every
12 months |
Standard single vision, bifocal, trifocal and lenticular covered in full after $25 co-pay. |
| Contact Lenses (in lieu of lenses and frames) | ||
| Contact Lens—Elective | Every
12 months |
$110 which can be used toward the evaluation, fitting and follow-up care. |
| Contact Lens—Medically necessary | Every
12 months |
Covered in full |
| Laser Vision | 5%–25% off | |
| Dental + Vision Monthly Premiums | Comprehensive | Preventive |
| Individual | $38.50 | $23.49 |
| Individual & Child(ren) | $77.65 | $44.07 |
| Individual & Spouse | $78.07 | $44.20 |
| Family | $117.48 | $61.73 |
- 1513 Country Club Rd
Sherwood, AR 72120 - 1-800-462-5410
- 1-877-992-1854
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