Dental Coverage

Oral health is closely tied to our overall well-being. Taking care of our teeth and gums can help prevent diseases, reduce the risk of chronic conditions and even support our mental health.

Memorial Hermann offers three dental plans, so you can choose the option that’s best for you:

  • Essentials Dental Preferred Provider Organization (DPPO)
  • In-network Smiles Dental Health Maintenance Organization (DHMO)
  • Full Coverage DPPO

Delta Dental Contact Information

Visit www.deltadentalins.com and download the Delta Dental mobile app to easily access your coverage details and find in-network providers.

If you have any questions about your coverage, claims or in-network providers or require an additional ID card, call:

  • Essentials DPPO and Full Coverage DPPO: 800.521.2651

(Group #: 07410)

  • In-network Smiles DHMO: 800.422.4234

(Group #: 76144)

Essentials DPPO

In-network Smiles DHMO

Full Coverage DPPO

At a Glance

Focuses on diagnostic and preventive services

Controls costs with in-network-only coverage

Provides the most comprehensive coverage

Best For

Those who only need routine preventive care

Those seeking a balance of coverage and cost

Those who need major care and services

What’s the Same

All three plans will be offered through Delta Dental and include $0 in-network preventive care (two routine cleanings per year; one every six months), as well as coverage for basic services like fillings, orthodontic care, oral surgery and more. 

What’s Different

The Essentials DPPO allows you the freedom to visit any licensed dentist, but you will receive greater benefits when you use a network dentist. This plan focuses on coverage for essential preventive and diagnostic care.

Diagnostic and preventive services are covered in full. After you meet your deductible ($50/individual, $150/family), the plan will pay 80% of the cost for basic services (e.g., fillings and simple tooth extractions).

This plan doesn’t offer coverage for any other services.

For more coverage details, see the Plan Comparison below.

The Full Coverage DPPO allows you the freedom to visit any licensed dentist, but you will receive greater benefits when you use a network dentist. This plan also offers comprehensive coverage for a range of services and covers orthodontia care for dependents up to age 19 only.

Note: Any eligible family member can contribute to the family deductible, but at least one person must meet the individual deductible before the family deductible requirements are met.

Diagnostic and preventive services are covered in full. After you meet your deductible ($50/individual, $150/family), the plan pays 80% of the cost for basic services, endodontics, periodontics and oral surgery and 50% of the cost for major services. After you meet a separate $50/member deductible, this plan also covers up to $1,500 for orthodontia, per lifetime.

For more coverage details, see the Plan Comparison below.

The In-network Smiles DHMO requires you to designate a primary care dentist and encourages regular visits with lower copays. Out-of-network care is not covered, except in certain emergency situations. However, all covered dependents are eligible for orthodontia care, regardless of age. 

To see what you’ll pay for care, refer to this DHMO fee schedule.

Choose What’s Right for You!

While our dental plans cover the same services, they differ in a few key ways. 

  • The Essentials DPPO has a lower premium and focuses on preventive and diagnostic care. If you typically only need your twice-yearly cleanings, this may be a good option for you.
  • The Full Coverage DPPO has higher premiums, and gives you more flexibility to choose any provider – though you will pay less out of pocket when you visit in-network providers. In addition, this plan covers orthodontia care for dependents up to age 19. 
  • The In-network Smiles DHMO costs less in premiums, and only offers in-network care. So, you must see an approved provider. In addition, this plan covers orthodontia care for anyone enrolled, including adults.  

What is your priority: Keeping your costs lower or having more provider options and more comprehensive coverage? Do you need orthodontia care for someone over the age of 19?

Essentials DPPO1

Full Coverage DPPO1

In-network Smiles DHMO2

In-Network and Out-of-Network

In-Network and Out-of-Network

In-Network Only

Annual Deductible

$50 per individual/ $150 per family (deductible is waived for diagnostic and preventive services)

$50 per individual/ $150 per family (deductible is waived for diagnostic and preventive services)

Not applicable

Benefit Maximum

$750 per person (diagnostic and preventive services don’t count toward maximum)

$1,500 per person (diagnostic and preventive services don’t count toward maximum)

Not applicable

Orthodontic Deductible

Not applicable

$50 lifetime deductible per person

Not applicable

Diagnostic and Preventive Services: Exams, Cleaning, X-Rays

You pay $0

You pay $0

Per DHMO fee schedule

Basic Services: Fillings and Simple Tooth Extractions

You pay 20%

You pay 20%

Per DHMO fee schedule

Endodontic (root canals)

Not covered

You pay 20%

Per DHMO fee schedule

Periodontics (gum treatment)

Not covered

You pay 20%

Per DHMO fee schedule

Oral Surgery

Not covered

You pay 20%

Per DHMO fee schedule

Major Services: Crowns, Inlays, Onlays and Cast Restorations, Bridges and Dentures

Not covered

You pay 50%

Per DHMO fee schedule

Orthodontic Benefits

Not covered

Dependent children to age 19: You pay 50%

Dependent children up to the age of 26 and adults (employee and spouse): per DHMO fee schedule

Orthodontic Maximums

Not covered

Plan pays: $1,500 lifetime

Per DHMO fee schedule

Enhanced Cleaning Benefits for Pregnancy

Not covered

Includes oral evaluation and cleaning

Per DHMO fee schedule
1 Includes Delta Dental PPO dentists and non-Delta Dental dentists.
2 Contract specialists may differ.

Note: Limitations or waiting periods may apply for some benefits; some services may be excluded from your plan. Reimbursement is based on Delta Dental maximum contract allowances and not necessarily each dentist’s submitted fee. You are responsible for any charges above allowed amounts when using a non-Delta Dental dentist.

The amount you pay for dental coverage is based on the plan you choose and who you choose to cover. It is deducted from your paychecks before taxes are calculated (i.e., on a pre-tax basis).

Essentials DPPO

Full Coverage DPPO

In-network Smiles DHMO

Coverage

FY26 Annual

FY26 Biweekly

FY26 Annual

FY26 Biweekly

FY26 Annual

FY26 Biweekly

Employee

$238.44

$9.17

$402.84

$15.49

$158.64

$6.10

Employee + Spouse

$465.12

$17.89

$785.76

$30.22

$363.36

$13.98

Employee + Child(ren)

$560.40

$21.55

$946.68

$36.41

$332.64

$12.79

Employee + Family

$870.48

$33.48

$1,470.48

$56.56

$469.80

$18.07

In many cases, your dentist will submit claims on your behalf. If your dentist does not submit claims, then you can submit the claims directly to Delta Dental by:

  1. Downloading a claim form from the website.
  2. Completing the form and attaching a copy of the dentist’s statement of treatment, including the dentist’s name, phone number and a description of each service performed.
  3. Making a copy for your records.
  4. Mailing the original claim and statement of treatment to the address provided on the claim form. Claims are generally processed within two (2) weeks unless additional information is required from you or the dentist.

If you have a dental emergency, you should:

  • Obtain routine or urgent care from any licensed dentist during normal office hours.
  • Preauthorization is not required for emergency treatment after normal office hours from a licensed dentist.
  • Out-of-pocket costs are likely to be lower if you receive emergency care from a dentist who is in your network.

Events