Quick Access to Common Resources
- Member Forms
- Submit A Claim
Existing members may submit a claim using the form below: - Dental Claim Form
- Enrollment Change Form
Use these forms to request changes to your existing coverage: - MN Individual and Family℠ – Elite 3500, Elite 1000 Enrolment Change Form
- MN Individual and Family℠ – Plan A, Plan B, Plan C, Plan D Enrollment Change Form
- MN Health Care Reform Individual & Family Enrollment Change Form
- ND Individual and Family℠ – Plan A, Plan B, Plan C Enrollment Change Form
- ND Health Care Reform Individual & Family Enrollment Change Form
- Authorization to Release Information Form
- Helpful Tools for Members
- Nominate your Dentist for Delta Dental Membership
- Request a copy of a check
Cost Estimator
Learn More
Our Dental Care Cost Estimator tool provides estimated cost ranges for common dental care needs.
