Plan comparison

MIT PPO Value Plan  DeltaCare  PPO Plus Premier Plan
Administered by Crosby Benefits Administered by University Health Plans Administered by University Health Plans
Individual plan annual cost   $254.64  $325  $488
Individual +1 dependent annual cost Option not available  $612  $975
Family plan annual cost $643.92 $921 $1,463
Annual maximum  None  $1,000 yearly cap for oral surgery, endodontic services and periodontic services  $1,250/person
Dentist network  PPO Network dentists  Select Primary Care Dentist from the DeltaCare Directory  PPO Network & Premier Network Dentists
Preventive and diagnostic care 100% coverage 100% coverage  100% coverage
Restorative services (Example: 1 white tooth filling) $100.50 $41  80% coverage (PPO Network) 60% coverage (Premier Network & Out-of-network)
Endontic services (Example: Front tooth root canal)  $634.69  $221  80% coverage (PPO Network) 60% coverage (Premier Network & Out-of-network)
Major restorative services (Example: Porcelain crown) $937.94 $750  80% coverage (PPO Network) 60% coverage (Premier Network & Out-of-network)

Note: Comparison above is for informational purposes only and does not cover every situation you may encounter.