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How the Dental Plans Work
Salem Health offers two Delta Dental plan options โ the Dental Basic plan or the Dental + Orthodontia plan. All family members must be enrolled on the same plan; mixing coverage options within a family is not permitted.
With both plans, you have the freedom to choose any dentist or dental care provider. When using a Delta Dental PPO dentist or a Delta Dental Premier dentist, the dentist may not charge you the difference between the plan allowance and the billed amount for covered services. Your out-of-pocket costs will be lower when you visit a Delta Dental PPO dentist.
Both plans fully cover preventive services, such as regular exams, cleanings and X-rays They also provide coverage for basic and major services, including fillings, crowns and extractions. What differentiates the two plans is orthodontic coverage. Only the Dental + Orthodontia plan includes orthodontic coverage for both adults and children.
Delta Dental PPO provider: $
Delta Dental Premier provider: $$
Out-of-network provider: $$$
| Delta Dental Passive PPO Network |
Dental Plan | Dental + Orthodontia Plan |
|---|---|---|
| Annual deductible | $25 individual/$75 family | $25 individual/$75 family |
|
Annual maximum (preventive services are not applied to annual) |
$1,500 per person | $1,500 per person |
|
Preventive services (e.g., oral exams, cleanings, bitewing, x-rays) |
0%; deductible does not apply | 0%; deductible does not apply |
|
Basic services (e.g., fillings, roots canals, oral surgery) |
20% after deductible | 20% after deductible |
|
Major services (e.g., crowns, bridges, implants) |
50% after deductible | 50% after deductible |
|
Orthodontia (for both adults and children) |
Not covered | 50% to lifetime maximum benefit of $1,500 per person |
2026 Dental Basic Summary
2026 Dental Basic Summary Spanish
2026 Dental+Ortho Summary
2026 Dental+Ortho Summary (Spanish)
Delta Dental NonDiscrimination
