American Water Benefits Overview - Enhanced 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 provider 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) | $2,500 | $2,500 |
| 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 | $2,500 | $2,500 |
