With Delta Dental's Individual and Family Plan, you save on dental services – including routine cleanings, fillings, crowns, X-rays, and much more.

Individual Plan enrollment is for consecutive 12-month period(s) and monthly premium payments are drafted by electronic fund transfer (EFT).

• Individual & Family Plan Covered Services Brochure (2012)
  --For Rates valid for January 1, 2012 effective dates

Who is eligible to enroll?

• Arizona residents 18 years of age or older.
• Individuals who are not currently Delta Dental of Arizona group plan enrollees.
• Individuals who are not eligible for group coverage through Delta Dental of Arizona.
• Eligible Dependents:
  • Your lawful spouse
  • Unmarried children under age 19 or 23 if full-time student, or those 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.
    
    Verification of dependent status or full time student status for children over age 19 may be required.

Are there waiting periods?

Yes. To help keep your premiums low, there are waiting periods for Type 3a & 3b services. However, from the date you are eligible, you can start saving immediately on Type 1 & 2 services.

• No waiting for Type 1 - (Cleanings, exams, etc)
• No waiting for Type 2 - (Fillings, extractions, etc)
• 12 months for Type 3a* - (Crown Repair, Root Canals, etc.)
• 24 months for Type 3b* - (Dentures, Fixed Bridgework, etc)

If within the past 60 days you have been covered under a Delta Dental group plan, and had at least 12 months of continuous coverage under that plan, waiting periods may be waived. Dentists, employees and dependents of dental offices do not qualify for this plan. For additional benefit information and limitations, please refer to the benefit booklet.

Important Note About Your Effective Date

When valid enrollment documentation and payment is received by DDAZ on the 1st through the 21st of the month, coverage will be effective the first of the month immediately following. When valid enrollment documentation and payment is received by DDAZ on the 22nd through the last day of the month, coverage will be effective the first of the second month.

Example: If enrollment documentation/payment is received January 15, 2012 - your coverage effective date is February 1, 2012; If enrollment documentation/payment is received January 25, 2012 - coverage effective date is March 1, 2012.