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.
| 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 |
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.
