Overview
- Plan issuer
- DeltaCare USA
- Child-only offering
- Allows Adult and Child-Only
- Plan type
-
HMO
The DeltaCare USA Basic Plan for Families plan is a Health Maintenance Organization (HMO) plan. Your care is limited to dentists who work for for the HMO. Out-of-network care is usually not covered, except in emergencies.
- Metal level
-
Low
Low coverage level plans have lower premiums but higher copays and deductibles. This plan is suitable for tose who use fewer dental services. You pay less each month, but more when you use dental services.
Contact
- Customer service number
- 1-800-471-9925
- Toll-free customer service number
- 1-800-471-9925
Coverage
Adult
- Routine dental services
- Yes
- Basic dental care
- Yes
- Major dental care
- Yes
- Orthodontics
- Yes
Child
- Routine dental check up
- Yes
- Basic dental care
- Yes
- Major dental care
- Yes
- Orthodontics
- Yes
Deductible
- Deductible
- Not Applicable
- Maximum out of pocket
- $350
- Deductible
- Not Applicable
- Maximum out of pocket
- $700
- Deductible
- Not Applicable
- Maximum out of pocket
- $350
Copay and Coinsurance
- Routine dental services
- No Charge
- Basic dental care
- $50
- Major dental care
- $390
- Ortodontics
- $3,250
- Routine dental services
- No Charge
- Basic dental care
- $50
- Major dental care
- $350
- Ortodontics
- $350
Premium payment
The premium is the amount you pay for health insurance each month. This does not include other healthcare costs such as your deductible, copayments, and coinsurance.
Your premium depends on who is covered by the insurance and their ages. Generally, premiums increase if there are more people covered or if people covered are older.
Premium rates
| Coverage | Monthly premium | Annual premium |
|---|---|---|
| Child (age 0-14) | $19.49 | $233.88 |
| Child (age 18) | $19.49 | $233.88 |
| Adult individual (age 21) | $22.49 | $269.88 |
| Adult individual (age 27) | $22.49 | $269.88 |
| Adult individual (age 30) | $22.49 | $269.88 |
| Adult individual (age 40) | $22.49 | $269.88 |
| Adult individual (age 50) | $22.49 | $269.88 |
| Adult individual (age 60) | $22.49 | $269.88 |
| Couple (age 21) | $44.98 | $539.76 |
| Couple (age 30) | $44.98 | $539.76 |
| Couple (age 40) | $44.98 | $539.76 |
| Couple (age 50) | $44.98 | $539.76 |
| Couple (age 60) | $44.98 | $539.76 |
| Couple (age 21) plus 1 child | $64.47 | $773.64 |
| Couple (age 30) plus 1 child | $64.47 | $773.64 |
| Couple (age 40) plus 1 child | $64.47 | $773.64 |
| Couple (age 50) plus 1 child | $64.47 | $773.64 |
| Couple (age 21) plus 2 children | $83.96 | $1,007.52 |
| Couple (age 30) plus 2 children | $83.96 | $1,007.52 |
| Couple (age 40) plus 2 children | $83.96 | $1,007.52 |
| Couple (age 50) plus 2 children | $83.96 | $1,007.52 |
| Couple (age 21) plus 3 or more children | $103.45 | $1,241.40 |
| Couple (age 30) plus 3 or more children | $103.45 | $1,241.40 |
| Couple (age 40) plus 3 or more children | $103.45 | $1,241.40 |
| Couple (age 50) plus 3 or more children | $103.45 | $1,241.40 |
| Single parent (age 21) plus 1 child | $41.98 | $503.76 |
| Single parent (age 30) plus 1 child | $41.98 | $503.76 |
| Single parent (age 40) plus 1 child | $41.98 | $503.76 |
| Single parent (age 50) plus 1 child | $41.98 | $503.76 |
| Single parent (age 21) plus 2 children | $61.47 | $737.64 |
| Single parent (age 30) plus 2 children | $61.47 | $737.64 |
| Single parent (age 40) plus 2 children | $61.47 | $737.64 |
| Single parent (age 50) plus 2 children | $61.47 | $737.64 |
| Single parent (age 21) plus 3 or more children | $80.96 | $971.52 |
| Single parent (age 30) plus 3 or more children | $80.96 | $971.52 |
| Single parent (age 40) plus 3 or more children | $80.96 | $971.52 |
| Single parent (age 50) plus 3 or more children | $80.96 | $971.52 |
Source
Our data is directly sourced from Healthcare.gov, the U.S. federal government's Health Insurance Marketplace®, created under the Affordable Care Act.
- Healthcare.gov, last accessed April 1, 2021
- "Dental coverage in the Marketplace," Healthcare.gov
- "Glossary," Healthcare.gov