Underwritten by Renaissance Life &

Health Insurance Company of America

Individual Dental Plans

Get affordable certified essential health benefit
dental coverage from the nations leading and most
experienced dental benefits administrator.
Good health starts with a healthy smile
A healthy smile is importantnot only to your oral health, but for your
overall health, too. In fact, your dentist can detect more than 120 signs and
symptoms of non-dental diseaseincluding cancer, diabetes, heart disease,
kidney disease, and osteoporosisduring a routine oral exam.*
Having dental coverage helps you get the care you need to stay healthy. It can
also help keep your overall health care costs down. Thats why we are pleased
to offer you quality individual dental benefits administered by Delta Dental.
After all, good health starts with a healthy smile!

*Sources: J Am Dent Assoc, Vol 134, No suppl_1,

41S-48S. 2003 American Dental Association and Dental
Management of TheMedically Compromised Patient, 7th
Edition, 2008, Mosby Elsevier, St. Louis, MO.

$ave on the care you need:

For example: A dentist may submit a $950 charge for a crown. With dental coverage, the participating dentist accepts a reduced
fee of $744. Thats an immediate savings of $206! Furthermore, having Delta Dental coverage means Delta Dental pays a
percentage from the already reduced fee. You can see how the advantages of having dental coverage can add up quickly!
Set by our
network agreements

Delta Dental
in-network
dentist

Submitted fee

Maximum
approved fee

$950.00

$744.00

Coverage level

50%

Amount Delta
Dental pays

Amount
you pay

$372.00

$372.00

61% decrease
from the dentists
submitted fee

The payment example above is for illustration purposes only. Fees and reimbursements
can vary by location and dentist. It does however represent how the payment is determined.

Delta Dental offers the dental benefits you need at an affordable price
Diagnostic and preventive careNo waiting periods or deductibles.
Annual maximum$1,000 annual maximum per covered person per benefit year.
No annual maximum limit on pediatric EHB.
Low deductible$50 deductible per covered person per benefit year.
Deductible only applies to basic and major services.
Exceptional customer serviceSpecialized representatives are available to assist you at (800) 971-4108.
Secure online access 24/7Delta Dentals secure online Individual Account Manager is a fast, secure way to locate
participating dentists, review your claims, access benefit information and more.

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Save money by staying in network with our nationwide network of dentists

Delta Dental provides access to two of the largest dental networks in the nation. You can go to any licensed dentist, but you
generally will save money if you go to a dentist who participates in one of our two networksDelta Dental PPO or Delta
Dental Premier. Thats because Delta Dental has established Maximum Approved Fees for nearly all dental services, and
participating dentists agree to accept the Maximum Approved Fee as full payment for those services. If the dentists fee
is higher than Delta Dentals, he or she cannot charge you the difference. This means you are responsible only for your
copayments and deductibles, if any, when you visit a Delta Dental participating dentist.
As an example, say you have met your deductible and visit your dentist for a basic covered service. If the estimated charge of
$100 is covered at 80 percent, heres the out-of-pocket cost based on the participation status of the dentist you choose:

Submitted
fee

Maximum
approved fee

Amount
Delta Dental pays

Amount
you pay

Delta Dental PPO dentist

$100.00

$70.00

$56.00

$14.00

Delta Dental Premier dentist

$100.00

$90.00

$72.00

$18.00

Nonparticipating dentist

$100.00

$87.00

$69.60

$30.40

The payment example above is for illustration purposes only. Fees and reimbursements
can vary by location and dentist. It does however represent how the payment is determined.

In this example, choosing

a Delta Dental PPO dentist
saves 54% more out of
pocket versus choosing the
nonparticipating dentist!

Using your benefits couldnt be easier

Delta Dental benefits are easy to use. Participating dental offices will complete and file claims for you, so there is no
paperwork for you and you dont have to wait to get reimbursed when visiting participating providers. And if you have any
questions, customer service representatives are available to assist you along the way.

Start smiling
brighter today
with Delta Dental!

Underwritten by Renaissance Life &

Health Insurance Company of America
Administered by Delta Dental Plan of Michigan, Inc.. Underwritten by Renaissance Life & Health Insurance Company of America, PO Box 1596, Indianapolis, IN 46206
NM EHB Plan Brochure v1

PA 10/13