State of Iowa Delta Dental Plan – Merit Employees

How an Individual Uses the Dental Insurance Plan

Dental care under this plan can be obtained from any provider; however, there are advantages to using participating providers who have contracts with Delta Dental of Iowa, the dental insurance plan administrator. A list of plan providers may be accessed via the web.

Participating providers will accept payment arrangements and file claims for you. Payment is made directly to these providers.

Nonparticipating providers have not agreed to accept Delta Dental’s payment arrangements. This means you are responsible for any difference between your dentist’s covered charges and the Delta allowance. These dentists are not responsible for filing your claims. Claims are settled directly with you and you are then responsible for making payment to your provider.

How Much an Individual Pays for Dental Services

Check Ups and Teeth Cleaning (Diagnostic and Preventative Services)

  • Dental Cleaning - 2 per year
  • Oral Evaluations - 2 per year
  • Fluoride Applications - once every 12 months for unmarried, dependent children under age 19
  • X-rays

Deductible:  none
Coinsurance:  0 %
Benefit Period Maximum:  $1,500 Total of all areas per person, per year

Cavity Repair and Tooth Extractions (Routine and Restorative Services)

  • Contour of Bone
  • Emergency Treatment
  • General Anesthesia/Sedation
  • Restoration of Decayed or Fractured Teeth
  • Limited Occlusal Adjustment
  • Routine Oral Surgery
  • Sealant Applications - $120/Lifetime
  • Space Maintainers

Deductible:  none
Coinsurance:  20 %
Benefit Period Maximum:  $1,500 Total of all areas per person, per year

Root Canals (Endodontic Services)

  • Apicoectomy
  • Direct Pulp Cap
  • Pulpotomy
  • Retrograde Fillings
  • Root Canal Therapy

Deductible:  none
Coinsurance:  50 %
Benefit Period Maximum:  $1,500 Total of all areas per person, per year

Gum and Bone Diseases (Periodontal Services)

  • Conservative Procedures (non-surgical)
  • Maintenance Therapy

Deductible:  none
Coinsurance:  50 %
Benefit Period Maximum:  $1,500 Total of all areas per person, per year

High Cost Restorations (Cast Restorations)

  • Crowns
  • Inlays
  • Onlays
  • Posts and Cores

Deductible:  none
Coinsurance:  50 %
Benefit Period Maximum:  $1,500 Total of all areas per person, per year

Straighter Teeth (Orthodontics)

  • Only for unmarried dependent children under the age of 19

Deductible:  none
Coinsurance:  50 %
Benefit Period Maximum:  $1500 per eligible dependent in a lifetime

The benefit period is the same as a calendar year. It begins the day your coverage goes into effect and starts over each January 1. This is true for as long as you have coverage.  (Current Info effective January 1, 2005)

Who Can Be Covered for Dental Insurance

Coverage is available as:

  • Employee only;
  • Employee and Family
    (This includes: spouse/domestic partner, children, or spouse/domestic partner and children)

    Dual University of Iowa employed spouses/partners and any children may not double insure each other or dependents under the plans where the University contributes towards the cost of the plans. This includes the health, dental, and AD&D insurance policies - an individual may only be included once under these policies.

Would you like more detailed information? 

You may download the full PDF iconState of Iowa Plan (pdf) from our web site.