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MEDICAL & PRESCRIPTION DRUG PLANS
Plan Option
Monthly premiums are for one person. For married couples, multiply the costs, in the table
to the left, by two. Premiums apply to Delta Air Lines retirees, spouses of current or former Delta Air Lines employees, surviving spouses of former Delta
Air Lines employees, and those with a Delta Air Lines pension.
Supplement-Type Standard
Supplement-Type Enhanced
Medicare Advantage Standard
Medicare Advantage Enhanced
Medicare Advantage Enhanced Plus
DENTAL PLANS
VISION PLANS
Medical & Prescription Drug Coverage
$239.99
$335.67
$108.52
$141.81
$163.44
You do not have to purchase medical and prescription drug coverage through the Insurance Trust in order to purchase Dental or Vision coverage. However, members who only purchase Dental and/or Vision coverage pay a $2 per month administration fee.
Delta Dental PPO (Ground & Flight Attendant)
Delta Dental PPO (Pilots)
Delta Dental HMO-Type
$49.76/$100.60 w/spouse
$58.92/$119.26 w/spouse
$25.41/$50.71 w/spouse
EyeMed Vision Plan
$6.44/$11.96 w/spouse
Insurance Trust For Delta Retirees | 2021 Benefits & Resources Guide | 27
SUMMARY OF BENEFITS & PLAN PREMIUMS
