member FAQ

Eligibility, ID Cards, Adding or Cancelling Coverage
How do I obtain a copy of my dental benefits?
What is my ID number?
Do I need an ID card?
Where can I get an ID card?
How do I obtain a corrected ID card if there's an error on it?
Can I upgrade my plan or add more coverage?
What is the Late Entrant limitation?
What is an Elimination Period?
How long is a child considered an eligible dependent?
Determining Benefits
How do I obtain my benefit information?
Who is authorized to obtain benefit information and claim status on my dental policy?
Do I need to get a pretreatment estimate for a procedure?
How many exams, cleanings and x-rays are covered?
My periodontal specialist told me I should have three or four cleanings a year, but my plan only covers two…why?
Is wisdom tooth removal (oral surgery) covered?
How are orthodontic benefits paid?
What is a missing tooth clause?
Choosing a Dentist
Can I see any dentist or am I required to choose one from your network providers?
What if I have a complaint about my dental provider?
How do I know if my dentist is part of the network?
Do I need a referral to see another dental provider?
Can I visit a dental provider in a foreign country?
The Appointment
What do I bring to my appointment?
How much will I have to pay at the time of my appointment?
Do I need to bring a claim form?
Claims Submission
Who submits the claim or pretreatment estimate?
How much time do I have to submit a claim?
Will you send benefit payments to me or to the provider?
What is your fax number for claims submission?
What is your mailing address for claims submission?
Do I have to use a certain claim form?
What information do you need for my student-dependent?
Understanding Payment and our Benefit Statements (Claim Explanations)
How do I check claim information?
How do I get a copy of an EOB (Explanation of Benefits) statement?
Why did you take the deductible/copayment again on my claim? I already paid it to the dental office.
Why are you paying the dental office? I already paid them.
Why did you pay me? Payment was supposed to go to the dental office.
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