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AARP Dental Insurance Plan
administered by Delta Dental Insurance Company

Plan claim form

When visiting a Delta Dental dentist, the dental office completes and submits a claim form to Delta Dental on your behalf.

If you choose to visit a Non-Participating/Non-Contracting dentist, you will need to file a claim following treatment. Please follow the instructions below:

  1. First, download and print a claim form by selecting your state from the list below. This requires Adobe Acrobat Reader. If you don't have this application already installed on your computer, click here for a free download.)
    State
    If your state is not listed, please call toll-free 1-866-583-2085.

  2. Complete # 1 through # 13 of the claim form and attach a copy of the dentist's statement of treatment, including the dentist's name and phone number (with area code). Delta Dental will use the dentist's statement to process the claim. It's very important that the statement include a description of each service the dentist performs. A claim cannot be processed without a Primary Enrollee ID Number. Please be sure to provide this information on the claim form.

  3. Once completed, make a copy of the form for your records and mail the original to:

    AARP Dental Insurance Plan
    c/o Delta Dental Insurance Company
    P.O. Box 2059
    Mechanicsburg, PA 17055-2059

Claims are usually processed within 2 weeks unless additional information is required from you or the dentist.

WDDICSTN063 05/07
© 2007 Delta Dental Insurance Company

The AARP Dental Insurance Plan is administered by Delta Dental Insurance Company. The plan is insured by Delta Dental Insurance Company in AK, AL, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, PR, TN, TX, UT, VI and WV (Policy DDIC1230), by Dentegra Insurance Company in AR, AZ, CA, CO, CT, HI, IA, ID, IL, IN, KS, KY, ME, MI, MN, MO, NC, ND, NE, NJ, NM, OH, OK, OR, RI, SC, SD, VA, WA, WI and WY (Policy DIC1230), and by Dentegra Insurance Company of New England in MA, NH and VT (Policy DICNE1230). Policy numbers may vary by state. AARP endorses the AARP Dental Insurance Plan. Delta Dental Insurance Company pays a fee to AARP and its affiliate for use of the AARP trademark and other services. Amounts paid are for general purposes of AARP and its members. AARP does not make dental plan recommendations for individuals. You are strongly encouraged to evaluate your needs before choosing a dental plan.

 

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