Orthodontia

2023 Plan Information

MetLife Option AMetLife Option BDelta Dental
Note

The figures in the chart below reflect what the Plan pays, with the exception of deductibles and out-of-pocket maximums, which employees pay.

Orthodontics

In-Network:
50% of discounted fee, up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

Out-of-Network:
50% of R&C, up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

In-Network:
50% of discounted fee, up to a $2,000 lifetime benefit maximum per child (children to age 19)

Out-of-Network:
Not covered

In-Network:
50% of discounted fee, up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

Out-of-Network:
50% of R&C or Allowed Amount (Delta Premier), up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

Orthodontics Lifetime Maximum Benefit

The orthodontics lifetime benefit maximum is combined across plan options.