Notice
Change Healthcare announced a breach of HIPAA privacy and is reaching out to individuals whose personal information may have been compromised. Although this incident does not involve Delta Dental of New Jersey or Connecticut, Change Healthcare is a vendor we used and we are providing this information to help our members who might be affected.
American Water Resources Benefits Overview - Basic Plan
PPO Network
Using a PPO dentist is considered in-network and will offer you the greatest savings on dental services and will maximize your benefits
Premier Network
Using a Premier Dentist is considered in-network and will offer you great savings on dental services. It is the largest network.
Out of Network
You have the freedom to choose any dentist that does not participate in either the PPO or Premier networks. Claims will be reimbursed, but there may be balance billing and your maximum will not go as far.
| In-Network | Out-of-network | |
|---|---|---|
| Service | If a Delta Dental PPO or a Delta Dental Premier Network Dentist is used | If a Non-participating Dentist is Used |
| Annual maximum (per person) | $1,500 | $1,500 |
| Annual deductible (waived for Preventive & Diagnostic) | ||
| Per person | $50 | $50 |
| Family aggregate | $100 | $100 |
| Preventive & Diagnostic | ||
| Exams (Frequency limitations apply) | 100% | 100% |
| Cleanings (Frequency limitations apply) | 100% | 100% |
| Bitewing X-Rays | 100% | 100% |
| Fluoride Treatment (Frequency limitations apply) | 100% | 100% |
| Basic Services | ||
| Fillings (composite fillings on all teeth) | 80% | 80% |
| Simple Extractions | 80% | 80% |
| Root Canals (Endodontics) | 80% | 80% |
| Periodontics (Surgical), Oral Surgery | 80% | 80% |
| Sealants, Space Maintainers | 80% | 80% |
| Repair of dentures | 80% | 80% |
| Major Services | ||
| Crowns & Gold Restorations | 50% | 50% |
| Bridgework, Full & Partial Dentures | 50% | 50% |
| Implants | 50% | 50% |
| Orthodontics (Child to Age 19) | ||
| Co-insurance | 50% | 50% |
| Lifetime maximum | $1,500 | $1,500 |
American Water Member Benefits and Resources
Delta Dental of New Jersey is a part of Delta Dental Plans Association. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories.
