Delta Dental Plan Options for Massachusetts Students
DELTACARE DENTAL PLAN
2023-2024 Policy Year Enrollment Form
This enrollment form is for the DELTACARE DENTAL PLAN. If you meant to enroll in the Total Choice Plan, please click "Enrollment Form" on the left of this page under the Total Choice section.
If you purchase the DeltaCare Dental Plan now, your coverage will be effective November 1, 2023 through August 31, 2024.The enrollment deadline is midnight on October 10, 2023.
TO CONTINUE THE ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:
If you have a social security number you are required to enter it below. If you are an international student and do not have a social security, please use your student ID and add leading zeros if necessary to make it a 9-digit number.
DeltaCare Dental Plan
Total Choice Dental Plan
Additional Information
- Electronic Toothbrush Discount
- Dental Wellness
- Oral Health Life Stages
- Pre-treatment Estimate Info
- Virtual Visits
Delta Dental Plan Options for Massachusetts Students
TOTAL CHOICE PPO PLAN
The Total Choice PPO Plan will have the following plan changes beginning with the 2021-22 policy year:
- There will be a $50 individual/$150 family deductible for all in-network Type 2 (Basic Restorative) and Type 3 (Major Restorative) services.
- There will be a 3 month waiting period on Type 2 (Basic Restorative) and Type 3 (Major Restorative) services. Students currently enrolled in the Total Choice Plan who are re-enrolling for the new policy year have already satisfied their 3-month waiting period.
Prior to enrolling, please review the full Summary of Benefits found HERE.