Reimbursement Level
Network Fee Schedule Maximum Plan Allowance 90th Percentile of the Reasonable and Customary Prevailing Fee

Base Plan

	PPO Network	Premier Network	Out-of-Network
Preventive Services (No deductible)	100%
Basic Services (After annual deductible	80%
Major Services (After annual deductible	50%
Ortho Services	Not covered
Maximum Annual Benefit	$1,500 for each enrolled individual
Annual Deductible	$100 per individual / $300 per family

 

Buy Up Plan

	PPO Network	Premier Network	Out-of-Network
Preventive Services (No deductible)	100%
Basic Services (After annual deductible	80%
Major Services (After annual deductible	50%
Ortho Services	50% up to $1,500 / No deductible
Maximum Annual Benefit	$2,000 for each enrolled individual
Annual Deductible	$50 per individual / $150 per family

⁽¹⁾ Out-of-network dentists may bill you for the difference between the covered dental expense determined by Delta Dental as the Reasonable & Customary (R&C) and the dentist's usual fee.


This overview highlights certain features of University of Missouri dental benefits. For full details, please refer to your Summary Plan Description (SPD). If there is a discrepancy between the wording here and the SPD, the document language will govern. University of Missouri reserves the right to amend, modify or terminate the dental plan at any time.