Dental Plan FAQ's

Frequently asked questions (FAQ) for Members:

Preferred Provider Organization (PPO) topics

Prepaid plan topics

Preferred Provider Organization (PPO) topics

About our PPO Networks

  1. What Preferred Provider Organization (PPO) Networks do you offer?
  2. How many dentists and locations are currently available through your PPO network?
  3. What do you do to ensure the quality of the networks?

Choosing a dentist

  1. How can I find a dentist?
  2. How do I schedule an appointment with a dentist?
  3. Can I see any dentist I want?
  4. What if I need to see a specialist?
  5. Why doesn't my dentist show up on your online directory/search?
  6. How can I recommend my dentist to participate in your PPO networks?

Enrollment and administration

  1. How do I sign up?
  2. If I decline coverage now and decide to enroll later are there any penalties and/or limitations?
  3. Are my dependents eligible for coverage under my plan?
  4. Is there a PPO network option available?
  5. What if I lose my Dental ID card or have a question about my plan?

Plan benefits

  1. I am enrolled in your dental program, but I don't know which one. How do I find out?
  2. Will my plan cover braces?
  3. What happens if I need dental care and I am out of the country?
  4. How will I know when I've met my deductible, annual/lifetime maximum?
  5. Is there a family deductible limit?

Claim questions

  1. Do I have to submit claim forms? And where do I send them?
  2. Do I have to get pre-approval for certain procedures?
  3. What is the most common cause for claims delay?
  4. What about services that are not covered by my dental plan?

Prepaid plan topics

Prepaid plans

  1. What is a prepaid plan?
  2. What are copayments and where can I locate the Copayment Schedule?
  3. What if my address or phone number changes?
  4. What if I have a question about my plan or lose my Dental ID card?
  5. Do I have to fill out a claim form after every visit?
  6. My former dentist was treating me for an ongoing problem. Now that I have joined the Plan, will the rest of this treatment be covered?

Choosing a Prepaid plan dentist

  1. How do I select a Prepaid Plan Dentist?
  2. Must all family members select the same Plan Dentist?
  3. How will the Plan Dentist know I am a patient?
  4. How do I make an appointment?
  5. What do I do if I need to cancel my appointment?
  6. How much and when do I have to pay for my dental visit?
  7. Can I change my Plan Dentist?
  8. What if I choose to see a dentist other than my selected Plan Dentist?
  9. If I have a dental emergency, do I need to see my Plan Dentist?
  10. If I need to see a specialist, how do I go about finding a Plan Specialist in my area?
  11. How do I know if a specialist accepts the Specialty Benefit Amendment (SBA)?