Forms and Resources

Get the resources you need to understand your dental benefits and manage your oral health, such as forms, benefit resources, and oral health materials.

Compliance

Individual Release of PHI Authorization
HIPAA Privacy Notice
Privacy Complaint Form
Martin's Point Generations Advantage Patients
- Medicare Opt–Out Acknowledgement and Financial Responsibility Form

Affordable Care Act Resources for Patients

Health Insurance Marketplace Dental Plans

Northeast Delta Dental is pleased to offer stand-alone dental plans to individuals, families, and eligible businesses through the Health Insurance Marketplace in Maine, New Hampshire, and Vermont.

Transparency in Coverage Policies

Nondiscrimination in Healthcare

Northeast Delta Dental

© 2023 Northeast Delta Dental. All Rights Reserved. Northeast Delta Dental is part of Delta Dental Plans Association. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories.