Dental Services2018-09-28T12:32:58+00:00

Preventive and Comprehensive Dental Services

Prominence Health Plan is pleased to partner with Delta Dental to provide optional preventive and comprehensive dental services through some of our health plans at an additional charge.*

Nevada Dental Evidence of Coverage
Texas Dental Evidence of Coverage

Preventive dental services include cleanings. There is no copayment for the office visit for preventive services.**

Comprehensive dental benefits include:

Benefit Plan Coverage
Basic Restorative 70%
Oral Surgery 50%
Simple Extractions 50%
Endodontics 50%
Surgical Periodontics 50%
Non-Surgical Periodontics 50%
Major Restorative 50%
Prosthodontics — Fixed and Removable 50%
Denture Repair and Relining 70%
Deductible (does not apply to Diagnostic and Preventive Services)
Per Patient/Calendar Year $50

You must visit a dentist in the Delta Dental network to receive covered plan services. Services received from providers outside this network may not be covered.

* In Texas, preventive dental services are included as part of the base plan. Monthly premiums for the optional dental coverage are: Nevada—$29; North Texas—$23; South Texas—$22.
** Limitations apply.

See a list of approved dentists

For more information, contact Delta Dental customer service at 855-643-8414 (TTY:711) 8 a.m. – 8 p.m., Monday through Friday.

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Last update 9/26/2018