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Dental Benefit

Explore your extra dental benefit through Generations Advantage. 

The Martin’s Point Generations Advantage Dental Benefit is administered by Northeast Delta Dental (NEDD).

With our dental coverage, there’s no waiting period—so you can start using your benefit as soon as you need it and low or no copays and coinsurance amounts make important preventive care affordable.

For more information, please see your Evidence of Coverage or reach Northeast Delta Dental by calling 1-800-832-5700 (TTY: 1-800-332-5905).

 

Find a Dental Provider

Important Note: When using the Network Provider Search Tool: Prime, Value Plus, and Alliance members choose the Martin's Point Generations Advantage Network. Select and Access members choose the Delta Dental PPO or Delta Dental Premier Network.

In-Network Dentist

Network requirements vary by plan. Please see Important Note above for how to select the correct network when using the Provider Search Tool.

NETWORK PROVIDER SEARCH TOOL
Out-of-Network Dentist

For a higher cost share, Generations Advantage LPPO plan members (Select & Access) may also see dentists who accept Medicare outside of the Delta Dental network.

VIEW COST SHARE INFORMATION
Have questions? We're here to help.

From October 1 to Mar. 31, we’re here 7 days a week, & Monday to Friday the rest of the year from 8am–8pm. 

Current Members:
 1-866-544-7504

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Benefit Maximums by Plan

Below are the specific dental benefit details for each Generations Advantage plan. Both 2025 and 2024 plan year cost shares are included.

Coverage as of 1/1/2025

Member Cost Shares (No Waiting Period and No Deductible)
Amounts under Categories A, B, and C Show What MEMBER Pays

Dental Benefits by Area Calendar Year Maximum Paid by Plan**  A  Diagnostic / Preventive  B  Basic Restorative  C  Major Restorative
Prime (HMO-POS)

Plan ID: H5591-015-001

ME Counties: Lincoln, Oxford, Piscataquis, Somerset, Waldo
NH Counties: Belknap, Carroll, Coos, and Grafton

All services must be received in network.

 $500  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Prime (HMO-POS)

Plan IDs: H5591-015-002 | H5591-006-001

ME Counties: Aroostook, Cumberland, Franklin, Hancock, Knox, Penobscot, Washington, York

All services must be received in network.

 $750  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Prime (HMO-POS)

Plan ID: H5591-006-002

ME Counties: Androscoggin, Kennebec, and Sagadahoc

All services must be received in network.

 $1,500  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Prime (HMO-POS)

Plan ID:  H5591-005

NH Counties: Cheshire, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan

All services must be received in network.

 $1,250  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Alliance (HMO)

Plan ID: H5591-003

All Maine and New Hampshire Counties

All services must be received in network.

 $2,500  $0 Office Visit Copay  20% Coinsurance  50% Coinsurance
Value Plus (HMO-POS)

Plan IDs: H5591-009 |
H5591-013

ME Counties: Aroostook, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo, and Washington

All services must be received in network.

  $2,000  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Select (LPPO)

Plan ID: H1365-001

ME Counties: All Counties
NH Counties: Cheshire, Coos, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan

For a higher cost share, Select (LPPO) plan members may also see dentists who accept Medicare in the complete Northeast Delta Dental network.

  $1,500  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Access (LPPO)

Plan ID: H1365-002

NH Counties: Belknap, Carroll, Coos, and Grafton

For a higher cost share, Access (LPPO) plan members may also see dentists who accept Medicare in the complete Northeast Delta Dental network.

  $1,000  $50 Office Visit Copay $50 Office Visit Copay and 50% Coinsurance $50 Office Visit Copay and 50% Coinsurance
Access (LPPO)

Plan ID: H1365-003

NH Counties: Cheshire, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan

For a higher cost share, Access (LPPO) plan members may also see dentists who accept Medicare in the complete Northeast Delta Dental network.

  $2,000  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance

Coverage as of 1/1/2024

Member Cost Shares (No Waiting Period and No Deductible)
Amounts under Categories A, B, and C Show What MEMBER Pays

Dental Benefits by Area Calendar Year Maximum Paid by Plan**  A  Diagnostic / Preventive  B  Basic Restorative  C  Major Restorative
Prime (HMO-POS)

Plan ID: H5591-015-001

ME Counties: Lincoln, Oxford, Piscataquis, Somerset, Waldo
NH Counties: Belknap, Carroll, Coos, and Grafton

All services must be received in network.

 $500  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Prime (HMO-POS)

Plan ID: H5591-015-002

ME Counties: Aroostook, Franklin, Hancock, Knox, Penobscot, and Washington

All services must be received in network.

 $750  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Prime (HMO-POS)

Plan IDs: H5591-005 |
H5591-006-001 | H5591-006-002 | H5591-006-004 | H5591-006-005

ME Counties: Androscoggin, Cumberland, Kennebec, Sagadahoc, and York
NH Counties: Cheshire, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan

All services must be received in network.

 $1,000  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Alliance (HMO)

Plan ID: H5591-003

All Maine and New Hampshire Counties

All services must be received in network.

 $2,500  $0 Office Visit Copay  20% Coinsurance  50% Coinsurance
Value Plus (HMO-POS)

Plan IDs: H5591-009 |
H5591-013

ME Counties: Aroostook, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo, and Washington

All services must be received in network.

  $1,000  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance
Select (LPPO)

Plan ID: H1365-001

ME Counties: All Counties
NH Counties: Cheshire, Coos, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan

Not Covered

Note: Select members pay a $40 Office Visit Copay for Medicare-covered dental services ONLY

 Not Covered Not Covered Not Covered
Access (LPPO)

Plan ID: H1365-002

NH Counties: Belknap, Carroll, Coos, and Grafton

For a higher cost share, Access plan members may also see dentists who accept Medicare in the full Northeast Delta Dental network.

  $1,000  $50 Office Visit Copay  Not Covered Not Covered
Access (LPPO)

Plan ID: H1365-003

NH Counties: Cheshire, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan

For a higher cost share, Access plan members may also see dentists who accept Medicare in the full Northeast Delta Dental network.

  $2,000  $50 Office Visit Copay  $50 Office Visit Copay and 50% Coinsurance  $50 Office Visit Copay and 50% Coinsurance

Coverage Categories

Below you will find a list of common dental procedures organized by coverage categories.

 A  Diagnostic / Preventive  B  Basic Restorative  C  Major Restorative

Diagnostic:

  • Problem-focused exams as needed
  • X-rays (complete series or panoramic film)
    once in a 5-calendar-year period
  • Bitewing X-rays once in a calendar year
  • X-rays of individual teeth as necessary

Preventive:

  • Oral exam and routine cleaning*

*NOTE ABOUT CLEANINGS:

2024 Plan Year: Enjoy enhanced preventive care with up to two cleanings per calendar year for all members with dental coverage, except Cumberland and York County Prime plan members, who are eligible for one cleaning. You may choose from Category A (preventive/routine) and/or Category B (periodontal). Office visit copays and coinsurances apply. Periodontal maintenance (cleaning) is not a covered benefit for Belknap, Carroll, Grafton, and Coos County Access plan members.

2025 Plan Year: Enjoy enhanced preventive care with up to two cleanings per calendar year for all members with dental coverage, except Cumberland and York County Prime plan members, who are eligible for one cleaning. You may choose from Category A (preventive/routine) and/or Category B (periodontal). Office visit copays/coinsurances apply. 

Restorative:

  • Amalgam (silver) fillings†
  • Resin restorations on anterior teeth and
    the buccal surface of bicuspids only

Oral Surgery:

  • Surgical and routine extractions

Endodontics:

  • Root canal therapy

Periodontics:

  • Periodontal maintenance (cleaning)*
  • Treatment of gum disease
  • Clinical crown lengthening once per tooth per lifetime

Denture Repair:

  • Repair of a removable denture to its original condition

Emergency Relief of Pain:

  • Brush biopsy once in a calendar year

†Additional costs may apply for resin fillings, please reach out to Northeast Delta Dental for more information.

Prosthodontics:

  • Removable and fixed
    partial dentures (bridge);
    complete dentures
  • Rebase and reline (dentures)
  • Crowns
  • Onlays
  • Implants