Dental Benefits - 2020

For Prime, Value, Focus DC, and Flex Plans

The Generations Advantage Prime (HMO-POS), Value (HMO), Focus DC (HMO SNP), and Flex (RPPO)* plans include the following benefits only when seeing a Delta Dental PPO/Martin's Point Generations Advantage network dentist in Maine, New  Hampshire, or Vermont.*

*Please note: Flex (RPPO) plan members may also receive covered dental services from out-of-network  providers for a higher cost share.


Prime Plan Comprehensive Dental

The Generations Advantage Prime (HMO-POS) plan includes the following benefits when seeing a Delta Dental PPO/Martin’s Point Generations Advantage network dentist in Maine, New Hampshire, or Vermont. This benefit overview is provided for summary purposes only.

Dental Plan Highlights

  • NO Waiting Periods for coverage
  • $50 office visit copay
  • Diagnostic & Preventive services are fully covered with NO coinsurance or deductible
    Includes your cleaning, exams, and X-rays
  • Basic Restorative services are covered with 50% coinsurance and a one-time $50 deductible
    Includes fillings, oral surgery, root canals, and periodontal maintenance
  • Major Restorative services are covered with 50% coinsurance and a one-time $50 deductible
    Includes dentures, bridges, crowns, onlays, and implants
  • $1,000 benefit maximum

Value Plan Comprehensive Dental

The Generations Advantage Value (HMO) plan includes the following benefits when seeing a Delta Dental PPO/Martin’s Point Generations Advantage network dentist in Maine, New Hampshire, or Vermont. This benefit overview is provided for summary purposes only.

Dental Plan Highlights

  • NO Waiting Periods for coverage
  • $5 office visit copay
  • Diagnostic & Preventive services are fully covered with NO coinsurance or deductible
    Includes your cleaning, exams, and X-rays
  • Basic Restorative services are covered with 20% coinsurance -  NO deductible!
    Includes fillings, oral surgery, root canals, and periodontal maintenance
  • Major Restorative services are covered with 50% coinsurance  -  NO deductible!
    Includes dentures, bridges, crowns, onlays, and implants
  • $2,000 benefit maximum

Focus DC Plan Comprehensive Dental

The Generations Advantage Focus DC (HMO) plan includes the following benefits when seeing a Delta Dental PPO/Martin’s Point Generations Advantage network dentist in Maine, New Hampshire, or Vermont. This benefit overview is provided for summary purposes only.

Dental Plan Highlights

  • NO Waiting Periods for coverage
  • $50 office visit copay
  • Diagnostic & Preventive services are fully covered with NO coinsurance or deductible
    Includes your cleaning, exams, and X-rays
  • Basic Restorative services are covered with 50% coinsurance and  a one-time $50 deductible
    Includes fillings, oral surgery, root canals, and periodontal maintenance
  • Major Restorative services are covered with 50% coinsurance and a one-time $50 deductible
    Includes dentures, bridges, crowns, onlays, and implants
  • $1,000 benefit maximum

Flex Plan Comprehensive Dental

The Generations Advantage Flex (RPPO) plan includes the following benefits when seeing a Delta Dental PPO/Martin’s Point Generations Advantage network dentist in Maine, New Hampshire, or Vermont or any out-of-network dentist. Cost shares differ for out-of-network services. This benefit overview is provided for summary purposes only.

In-Network Dental Plan Highlights

  • NO Waiting Periods for coverage
  • $50 office visit copay
  • Diagnostic & Preventive services are fully covered with NO coinsurance or deductible
    Includes your cleaning, exams, and X-rays
  • Basic Restorative services are covered with 50% coinsurance and a one-time $50 deductible
    Includes fillings, oral surgery, root canals, and periodontal maintenance
  • Major Restorative services are covered with 50% coinsurance and a one-time $50 deductible
    Includes dentures, bridges, crowns, onlays, and implants
  • $1,000 benefit maximum (In-and-Out-of-Network combined)

Out-of-Network Dental Plan Highlights

  • NO Waiting Periods for coverage
  • $50 office visit copay
  • Diagnostic & Preventive covered at 50% with NO deductible
    Includes your cleaning, exams, and X-rays
  • Basic Restorative services are covered with75% coinsurance and a one-time $50 deductible
    Includes fillings, oral surgery, root canals, and periodontal maintenance
  • Major Restorative services are covered at 75% coinsurance and a one-time $50 deductible
    Includes dentures, bridges, crowns, onlays, and implants
  • $1,000 benefit maximum (In-and-Out-of-Network combined)

Delta Dental PPO/Martin’s Point Generations Advantage Dental Network
Plan benefits are available only when you receive your dental care from a Delta Dental PPO/Martin's Point Generations Advantage network dentist in Maine, New Hampshire, or Vermont.
  • No Balance Billing: Participating dentists accept Northeast Delta Dental’s fees for services as payment in full.
  • No Claims Paperwork: Participating dentists will prepare and submit claims for you.
  • Direct Payment: Northeast Delta Dental pays participating dentists directly, so you don’t have to pay the covered amount up front and wait for reimbursement.

To find out if your dentist participates in the Delta Dental PPO/Martin’s Point Generations Advantage dental network, please use the Delta Dental Dentist Search tool, or call the Northeast Delta Dental Customer Service Department at 1-800-832-5700 (TTY: 1-800-332-5905) Monday through Friday, 8 am–4:45 pm.

Claim Process for Participating Dentists
Present your Generations Advantage member ID card to your participating dentist at the time of your visit. Your participating dentist will submit your claim to Northeast Delta Dental. Members can register online to view claims and benefit information.

Nonparticipating Dentists
For all plans except Flex, benefits are available under your policy only when you receive your dental care from a Delta Dental PPO/Martin's Point Generations Advantage network dentist in Maine, New Hampshire, or Vermont. Nonparticipating dentists are welcome to join the Delta Dental PPO/Martin’s Point Generations Advantage dental network at any time.

Identification Cards
Your Generations Advantage member ID card includes your dental group number and the Northeast Delta Dental customer service phone number. Your member ID number for dental benefits is the same as your Generations Advantage Prime, Value, Focus DC, or Flex plan member ID number.

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