Enroll in a healthier smile. Information Guide for your AARP Dental Insurance Plan ® insured and administered by Delta Dental Insurance Company 41-D-1101-001 A beautiful smile. A healthier you. You use your smile all the time…so why not give it the care it deserves? Keep it healthy with the AARP Dental Insurance Plan, administered by Delta Dental Insurance Company (Delta Dental), designed exclusively for AARP members. Delta Dental created this AARP-endorsed dental insurance plan to provide you with the best possible combination of dental benefits and cost savings. Remember, a healthy smile doesn’t just make you look good, it also may positively impact your overall health. Just like you, it deserves the best! This guide provides information about the benefit plans available and steps to get you started. If you choose to enroll in the plan, signing up is easy. Keep smiling. It’s good for you. 1 Choose from two plan options The AARP Dental Insurance Plan lets you choose from two plan options with two different benefit levels. The eligible dental procedures covered, waiting periods and most other aspects of the plan are identical under the two options. Both plans cover three cleanings per year. There are differences in the copayment levels, calendar year deductible and calendar year maximum benefit amount. These specific differences are noted in red in the following chart. *DeltaDental’spaymentunderthisplanislimitedtotheapplicablepercentageofthelesserof: a)yourdentist’sactualcharges;orb)theDeltaDentalPPOsmmaximumPlanAllowance(the highestamountthatDeltaDentalwillpaytoaDeltaDentalPPOdentistwhereyoureceived theservices).Youwillberequiredtopaythebalanceofthedentist’sfeenotpaidbyDelta Dental.WhenreceivingtreatmentfromaDeltaDentalPremier®(Premier)dentist,youmaybe requiredtopayanycostabovetheDeltaDentalPPOmaximumPlanAllowance,uptoyour dentist’sPremiermaximumPlanAllowance.When receiving treatment from a Non-Delta Dental dentist, there is no limit regarding their fees. DeltA DentAl PlAn A PlAn B Delta Member Delta Member BeneFIt ChARt Pays* Pays Pays* Pays Benefits in Year 1 Diagnostic and preventive (includes exams, x-rays and cleanings). NOTE: In Plan A, no deductible required 100% 0% 80% 20% for diagnostic or preventive services. In Plan B, Calendar Year Deductible applies. Periodontal maintenance cleanings 80% 20% 50% 50% (gum cleanings) Denture repairs 80% 20% 50% 50% Restorations (fillings) 50% 50% 50% 50% Oral surgery 50% 50% 50% 50% Endodontics (root canals) 50% 50% 50% 50% Additional Benefits after 1 Year of Continuous enrollment Periodontics (gum disease treatment) 50% 50% 50% 50% Crown and cast restorations 50% 50% 50% 50% Dental Implant Services 50% 50% 50% 50% Prosthodontics (dentures) 50% 50% 50% 50% Temporomandibular Joint Dysfunction (TMJ) 50% 50% 50% 50% Additional Benefits with Annual Rate Payment Not a benefit Dental Accident ($1,000 lifetime maximum) 100% 0% in Plan B Deductibles and Maximums Per enrollee Calendar Year Deductible $50 $100 Calendar Year Maximum Benefit $1,500 $1,000 Temporomandibular Joint Dysfunction— $300 $300 Lifetime Maximum Items in red indicate the differences between Plan A and B. 2 Choose your dentist Under the AARP Dental Insurance Plan, you have the freedom to visit any licensed dentist of your choosing. However, selecting a Delta Dental network dentist allows you to limit your out-of-pocket costs. The following table further explains the differences SM when selecting a Delta Dental PPO , ® Delta Dental Premier or Non-Delta Dental dentist. Delta Dental PPO SM Delta Dental Premier® non-Delta Dental Dentists (Premier) Dentists Dentists DentIst’s Fees Provide treatment at Provide treatment at Do not accept set or moderate fees; accept reduced, pre-negotiated pre-negotiated fees; the Delta Dental PPO fees; accept the Premier may charge full cost of Maximum Plan Allowance Maximum Plan Allowance treatment as payment in full* as payment in full* MeMBeR PAYMent** Deductible Deductible Deductible + + + Copayment/Coinsurance Copayment/Coinsurance Copayment/Coinsurance + + Difference between the Difference between the Delta Dental PPO Maximum Delta Dental PPO Maximum Plan Allowance* and the Plan Allowance* and the Premier Maximum Plan dentist’s full fee Allowance* ClAIM PROCess Delta Dental PPO dentists Premier dentists handle Non-Delta Dental dentists handle all claims and bill all claims and bill Delta may or may not handle Delta Dental directly Dental directly claims paperwork Member receives notice Member receives notice Member may have to pay explaining the portion of explaining the portion of up front, then submit the bill Delta Dental and the the bill Delta Dental and the claim to Delta Dental to member are responsible member are responsible be reimbursed for paying for paying * Delta Dental PPO Maximum Plan Allowance and Premier Maximum Plan Allowances may vary by dental office and/or dental specialty. ** Member is responsible for any amount over the plan calendar year maximum benefit and any non-covered service. 3 enroll You can sign up for the AARP Dental Insurance Plan in three easy ways: Visit www.deltadentalins.com/aarp Mail the enclosed enrollment form in the postage-paid business reply envelope Call toll-free at 1-866-290-2939 (TTY: 1-800-735-2929) Savings you can smile about. The AARP Dental Insurance Plan not only helps you and your family maintain your oral health, it can also help you manage unexpected dental expenses. Here are just a few ways you can save money: Benefits for the most common procedures Cleanings, oral exams, x-rays, denture repairs, oral surgery, root canal treatments and more are eligible benefits beginning the first day of the month following your date of enrollment. More savings as you go Services such as crowns, bridges and dentures are available after the first 12 months of continuous enrollment. Fixed premiums* Your premium is guaranteed not to increase for the first two years of your continuous enrollment. three cleanings per year That’s one more cleaning per year than most comparable dental plans. If you have any questions, please call toll-free 1-866-290-2939 (TTY: 1-800-735-2929) or visit us online at www.deltadentalins.com/aarp. Keep smiling. It’s good for you. * Premium rates may vary according to the plan and options you select on your enrollment form. AARP Dental Insurance Plan c/o Delta Dental Insurance Company P.O. Box 2059, Mechanicsburg, PA 17055-0759 The plan is insured and administered by Delta Dental Insurance Company (Policy DDIC1230). Delta Dental Insurance Company pays a royalty fee to AARP for use of the AARP intellectual property. Amounts paid are used for the general purposes of AARP and its members. Neither AARP nor its affiliate is the insurer. AARP and its affiliate are not insurance agencies or carriers and do not employ or endorse insurance agents, brokers, representatives or advisors. AARP does not recommend health related products, services, insurance or programs. Insurance products carrying the AARP name are intended to be competitive products and may not be the lowest priced products. You are strongly encouraged to evaluate your needs.