Delta Dental of New Mexico

1
Dental Plan BenefitsEffective July, 2008
State of New Mexico General Services
Department Risk Management Division
Administered by Delta Dental of New Mexico
Oral Health is Our Passion Quality Benefits,
Quality Dentists
Oral Health is Our Passion Quality Benefits,
Quality Dentists
Oral Health is Our Passion Quality Benefits,
Quality Dentists
Oral Health is Our Passion Quality Benefits,
Quality Dentists
Delta Dental of New Mexico????
Delta Dental of New Mexico????
Delta Dental of New Mexico????
Delta Dental of New Mexico????
administering the dental program for
administering the dental program for
administering the dental program for
administering the dental program for
State of New Mexico
State of New Mexico
State of New Mexico
State of New Mexico
General Services Department
General Services Department
General Services Department
General Services Department
Risk Management Division
Risk Management Division
Risk Management Division
Risk Management Division
2
GSD/RMD Dental PlanProvider Network Overview
3
GSD/RMD Dental Plan

• Calendar Year Deductible
• Does not apply to Diagnostic Preventive
• Services or Orthodontic Services
• 50 per enrolled person
• 150 aggregate per family
• Calendar Year Maximum
• 1750 per enrolled person

4
GSD/RMD Dental PlanBenefits Overview
Out of network dentists may balance bill
patients for amounts over Plan fee allowables.
5
GSD/RMD Dental PlanBenefits Overview
Out of network dentists may balance bill
patients for amounts over Plan fee allowables.
6
GSD/RMD Dental PlanBenefits Overview
Out of network dentists may balance bill
patients for amounts over Plan fee allowables.
7
GSD/RMD Dental PlanBenefits Overview
Out of network dentists may balance bill patients
for amounts over Plan fee allowables.
8
GSD/RMD Dental PlanPatient Disclosure
Patient Disclosure Youre
entitled to it!

• PPONEW MEXICO Dentists Guarantee
• Upon request, a pre-treatment cost range
  will be provided by your dentist.
• You and your dentist agree.
• Pre-determination of benefits from Delta
  Dental is recommended (not required)
  for expensive procedures.

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GSD/RMD Dental PlanInformation Available 24/7! 

• Online access to personalized benefit
  information, oral health information,privacy
  policies and more. No software to purchase or
  download required.
• Featured Plan Information Available at
  deltadentalnm.com in the Subscriber Section
• Go to Subscriber Materials, then sign in with
  your group number (8523).View, print, or save
  coverage documents
• Summary of Benefits
• Dental Benefit Handbook
• Network Information Page
• PPONew Mexico Provider Directory
• Consumer Toolkit
• Select the Consumer Toolkit link, sign in, and
• Verify eligibility of subscriber and dependents

www.deltadentalnm.com
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GSD/RMD Dental PlanCustomer Service
Great service is our way of saying Thank you
for your enrollment.
All claims and customer services provided
locally. No frustrating phone menu of options
from which to choose. Talk to a local
representativewithin 45 seconds of calling!

• Experienced Benefit Service Representatives
• Available Monday Friday 800 AM - 430 PM (MST)
• 505-855-7111 or Toll Free 1-877-395-9420

www.deltadentalnm.com