Plan comparison

MIT PPO Value Plan  DeltaCare  PPO Plus Premier Plan
Administered by Crosby Benefits/MIT 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  $988
Family plan annual cost $643.92 $921 $1,476
Annual maximum  None $1,000 yearly cap for oral surgery, endodontic services and periodontic services  $1,000/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 (PPO Network), 80% coverage (Premium Network Dentists & Out-of-network)
Restorative services (Example: 1 white tooth filling) $102.51 $41 80% coverage (PPO Network) 60% coverage (Premier Network & Out-of-network)
Endontic services (Example: Front tooth root canal)  $647.38  $221 80% coverage (PPO Network) 60% coverage (Premier Network & Out-of-network)
Major restorative services (Example: Porcelain crown) $931.74

to

$956.70

$614-750 850% coverage (PPO Network) 30% coverage (Premier Network & Out-of-network)

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