Delta Dental Plan of Oregon offers this marketplace health insurance plan (Plan ID 28415OR0260001) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Oregon). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Low Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
See policy for limits. 6-month exclusion period for age 19 and over if member does not have 12 continuous months of prior dental coverage with no more than a 90-day break in coverage from the end of the old policy to the effective date of the new policy.
Exclusions: See policy for exclusions
Dental Check-Up for Children
0.00%
Tier 1 in-network0.00%
Out-of-network20.00%
Limit: 1.0 Exam(s) per 6 Months
See policy for limits
Exclusions: See policy for exclusions
Major Dental Care - Adult
50.00%
Tier 1 in-network50.00%
Out-of-network50.00%
Limit: 1200.0 Dollars per Year
See policy for limits. 12-month exclusion period for age 19 and over if member does not have 12 continuous months of prior dental coverage with no more than a 90-day break in coverage from the end of the old policy to the effective date of the new policy.
Exclusions: See policy for exclusions
Orthodontia - Adult
Coverage details pending
nan
Exclusions: nan
Orthodontia - Child
50.00%
Tier 1 in-network50.00%
Out-of-network50.00%
For under age 19 and necessary to treat cleft palate with or without cleft lip.
Exclusions: See policy for exclusions
Routine Dental Services (Adult)
0.00%
Tier 1 in-network0.00%
Out-of-network20.00%
Limit: 1200.0 Dollars per Year
See policy for limits
Exclusions: See policy for exclusions
Variant attributes
Delta Dental PPO MAC · Variant 28415OR0260001-00
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard Low Off Exchange Plan
HIOS Product ID
28415OR026
Metal Level
Low
Plan ID (Standard Component ID with Variant)
28415OR0260001-00
Plan Marketing Name
Delta Dental PPO MAC
Plan Variant Marketing Name
Delta Dental PPO MAC
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
28415
Issuer Marketplace Marketing Name
Delta Dental Plan of Oregon
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
Yes
Network ID
ORN001
Out of Country Coverage
Yes
Out of Country Coverage Description
Out-of-network coverage
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
Out-of-network coverage
Service Area ID
ORS004
State Code
OR
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out
Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group
$850 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$425 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$425
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
