Dental
coverage for a broad range of preventive care, basic, and major dental services
The Mondelēz Global Dental Plan (Dental Plan) offers coverage through Delta Dental of Illinois (Delta Dental), including orthodontia coverage for both adults and children.
You don’t have to enroll for medical coverage through MDLZ to elect dental coverage. View a summary of your in-network benefits below.
| Coverage Option | $2,000 Maximum With Orthodontia |
|---|---|
| Contribution Amount | Note: If applicable, the current contribution amount you pay is on MyBenefits Online. |
| Annual Benefits Maximum | $2,000 per person |
| Annual Deductible | $50 individual (up to $150 family limit) |
| Preventive Care Includes routine exams, cleanings, sealants up to age 19, and other preventive/diagnostic services |
Covered 100% (deductible doesn’t apply) |
| Basic Services Includes fillings |
You pay 20% after deductible |
| Major Services Includes crowns, bridges, and onlays |
You pay 50% after deductible |
| Orthodontia | You pay 50% (no deductible) Note: $2,000 lifetime maximum benefit per person—adult and child |
Note: For services over $200, you’re encouraged to obtain prior authorization, even though it’s not required.
Save money with a Delta Dental preferred provider
Network providers offer services at a discount, plus conveniently submit claims on your behalf. You can use out-of-network providers if you wish, but your out-of-pocket costs may be higher. In addition, you may be responsible for filing your own claims.
More Information
Access detailed information about the coverage option on MyBenefits Online (in the Reference Center).
Looking to Save money with a Delta Dental Preferred Provider?
Network providers offer services at a discount, plus conveniently submit claims on your behalf. If you wish, you can use out-of-network providers too. But, your out-of-pocket costs may be higher. In addition, you may be responsible for filing your own claims.
Looking for more details?
Access more dental coverage details, including the Dental Transition of Care Guidelines document and the provider look-up tool on MyBenefits Online. Or visit the Delta Dental website.