Notice
Wednesday September 30: Our Customer Service hours will be 8:00 AM to 11:45 AM EST due to team training.
To view benefit information and claim status at any time, you can sign into your account or use our Interactive Voice Response System 24/7 at (800-452-9310).
Sanofi US Benefit Summary
| Service | PPO Plus Premier |
| Preventive & Diagnostic Exams, cleanings, bitewing x-rays, (each twice per calendar) Fluoride treatment (once per calendar year, children to age 19) Sealants |
100% |
| Remaining Basic Fillings, extractions Endodotics (root canal) Periodontics, oral surgery Repair of dentures |
80% |
| Crowns & Prosthodontics Crowns & gold restorations (over natural teeth) Bridgework, full & partial dentures Implants TMJ |
50% |
| Calendar Year Maximum (per patient, waived on Preventive & Diagnostic) |
$2,000 |
| Calendar Year Deductible (waived on Preventive & Diagnostic) Per person Family aggregate deductible |
$25 $75 |
| TMJ/Jaw Disorder Lifetime Maximum |
$1,000 |
| Orthodontic Benefits, full comprehensive treatment (child only) Orthodontic deductible Lifetime Maximum (per patient) |
50% $50 $1,500 |
| |
Your dentist's network will impact how much you pay. Dentists that help participate in the Delta Dental PPO will have the lowest costs and will save you the most out of pocket expense. Dentists that participate in Delta Dental Premier, are participating Delta Dental dentists, but you will pay a greater portion of the cost if utilized. If you receive services from a non-participating, out of network dentists, you will pay the most out of pocket and are responsible for your coinsurance amount plus the difference between Delta Dental's approved fee and the dentist submitted fee for the claim.
