Your Delta Dental Plan Highlights

If you have questions, review your Missouri Consolidated Health Care Plan (MCHCP) Member Handbook. On the MCHCP web site, www.mchcp.org, click on "State Members" under "Plans & Programs" select "Dental Plan" from the drop-down menu. You can also call Delta Dental's Benefit24 service line at 1-866-737-9802 for personal and automated assistance. If you are a prospective member, simply press "5" for personal service. You may also send an e-mail to StateOfMOService@ddpmo.org and receive a prompt response from a customer service representative during business hours.

Delta Dental Benefit Plan1
Plan
Pays
You
Pay
A Diagnostic and Preventive Services
  • Examinations*
  • Prophylaxes (teeth cleaning)*
  • Fluoride*
  • Extra cleanings with certain health conditions2
  • Bitewing radiographs (X-rays)
  • Sealants for children and adults
  • Brush biopsy (diagnostic procedure for oral cancer)

    * Most routine, preventive care no longer counts against your plan year maximum benefit amount.
100%
0%
NO DEDUCTIBLE
B Basic and Restorative Services
  • Emergency palliative treatment
  • Space maintainers
  • All other radiographs (x-rays)
  • Minor restorative services (fillings)
  • Simple extractions
80%
20%
C Major Services3
  • Prosthetic repair
  • Oral surgery
  • Periodontics
  • Endodontics (root canal)
  • Prosthodontics (bridges, dentures, partials)
  • Implants
  • Major restorative services (crowns, inlays)
50%
50%
Individual Annual Deductible
(for B and C services)
$50 per person
Maximum Benefit
(per covered person per year)
$1,000

1This is an outline of your benefits highlights. For more detailed information, visit the Overview, Limitations and Exclusions section of this web site.

2Those eligible for added cleanings include people diagnosed with periodontal disease, pregnant women, people with diabetes, people with suppressed immune systems, those with kidney failure or those undergoing dialysis.

 

3For major care, there is a one-year waiting period, which will be waived with proof of 12 months of continuous dental coverage for major services, immediately prior to enrollment in the MCHCP Delta Dental plan.

 

To view your dental plan Limitations, visit the Overview, Limitations and Exclusions section.