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Frequently Asked Questions

If you purchased your individual plan prior to August 22, 2013, your coverage is likely provided via one of our legacy plans. The following FAQs apply to our legacy individual and family dental and vision plans only.

If you purchased your individual plan after August 22, 2013, please visit DeltaDentalCoversMe.com for more information.

  1. Who is eligible to renew an individual plan?
You are eligible to renew your individual and family dental and vision insurance coverage if:
  • You are an Arizona resident and age 18 or older.
  • You are not currently a Delta Dental of Arizona group plan enrollee.
  • You are not eligible for group coverage through Delta Dental of Arizona.

Eligible dependents include:
  • Your lawful spouse
  • Unmarried children under age 19 or 23 (if a full-time student) or children of your lawful spouse, including newborn children, stepchildren, disabled children, persons under legal guardianship substantiated by a court order, legally adopted children and children placed for adoption with you in accordance with applicable state or federal law.

Note: Verification of dependent status or full-time student status for children over age 19 may be required.

  2. If I have coverage or am offered coverage through my employer can I renew an individual plan?
If you are a current Delta Dental of Arizona member or are offered Delta Dental of Arizona by your employer, you are not eligible to renew an individual plan. If you are enrolled in a dental plan through another carrier, you are eligible to renew, however, your benefits under this dental coverage policy would be coordinated as secondary.

  3. What are my options for renewing an individual plan?
If your dental benefits are provided through a legacy Individual and Family Plan, you have a few options at renewal: renew your legacy plan; make changes to your legacy plan; or switch over to a new plan. For more information on these options, visit our legacy renewal options page.

  4. Will my dependents need an ID card with their own name?
No. It is common practice to show only the primary subscriber's name on the identification card. Dental offices are familiar with this practice and will be able to confirm dependent benefits with the subscriber's information.

  5. Do I need to choose a participating Delta Dental PPO plus Premier dentist?
You may visit any dentist, but you will have less out-of-pocket expenses if you see one of Delta Dental's network dentists.

  6. Can my dentist participate in Delta Dental's PPO plus Premier network?
Yes. Just have your dentist call Delta Dental of Arizona and ask for "Professional Relations." It's easy, and there is no cost for your dentist to join.

  7. What is my benefit year?
Your benefit year is the 12-month period beginning on your effective date for the calculation of benefits, coinsurance, and deductibles. For example, if your effective date is February 1, your benefit year will be from February 1 through January 31 of each year.

  8. Is the benefit year maximum an individual or a family maximum?
The maximum is for each person enrolled in the dental plan.

  9. What is a waiting period?
A waiting period is the amount of time that must elapse between effective date and the day that you may receive a benefit.

10. How do I know if items like sealants, space maintainers, oral surgery, braces, dentures, cosmetic procedures etc. are covered benefits?
For information on whether a specific service is covered by your plan, please refer to the appropriate benefit booklet or contact our customer service team.

11. How do I change my address, add/remove dependents, update my EFT account, etc?
If you purchased your Individual and Family Plan prior to August 21, 2013, and want to make changes to your coverage, please complete a Family Status Change Form.

12. What are the terms and conditions for cancellation of the individual plan?
If you purchased your individual plan prior to August 21, 2013, your coverage is likely provided via one of our legacy plans. Enrollments are for consecutive 12-month period(s) and the monthly/annual premium payment is subject to change on the anniversary date. Non-compliance with these terms voids any benefits during that enrollment period. Should a member decide to cancel the plan, a 30-day written notice is required. Once notice is received, the policy will be cancelled at the end of the month and billing will not be prorated. Download the Individual Plan Cancellation Request Form.


 

Policies contain general and specific exclusions and limitations. This means certain dental services may not be covered under every policy. Also, coverage for certain dental services is subject to conditions and other limitations, such as the number of times they may be covered in a given time period. You should obtain these exclusions and limitations and review them prior to enrollment and renewal. If you have a legacy plan, please refer to your benefit booklet for details. If you do not have a legacy plan, these exclusions and limitations are available during the quoting process at www.DeltaDentalCoversMe.com.
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