To receive benefits from the plan for covered dental expenses from an out-of-network provider, you may need to file a claim form with Delta Dental. Separate claim forms must be submitted for each person filing a claim. Claim forms are available at www.deltadentalins.com.

To download a claim form, click "Enrollees," then "Managing Costs", and then "How to file a Dental Claim", and then "Delta Dental PPO, DPO and Delta Dental Premier."

Complete claim forms and itemized bills should be sent to the address noted on the claim form.

Before you or your provider submits your claim form, make sure you include your member ID and account number located on your benefits ID card.