Dental Health Maintenance Organization (DHMO) Plan
|How the United Concordia DHMO Plan Works|
|Preventive and diagnostic dental care is covered in full, while restorative and other major services are offered at a reduced cost when services are received from a Concordia Plus network dentist.|
|The Smile for Health® Maternity Dental Benefit provides women with additional dental cleaning during pregnancy. This extra cleaning can help control pregnancy gingivitis and help prevent periodontal (gum) disease, which has been linked to premature and low-birthweight babies.|
|There are no deductibles and no yearly benefit maximums.|
|There are no claim forms and you are only responsible for applicable copayment amounts (claim submission is necessary for out-of-area emergency care).|
|After enrolling through the state using the Interactive Voice Response (IVR) system (see State of Maryland July 2012-June 2013 Benefits Guide), each enrolled family member can select a different primary dental office from the Concordia Plus dental network. This office will provide, or arrange for, all dental care. You, or an enrolled family member, can change your primary dental office at any time. Changes made prior to the 15th of the month are effective the 1st of the following month. You must obtain a referral from your primary dental office to see a specialist.|
|Orthodontic services are available for both adults and children. This plan does not cover services for orthodontic work in progress. Please call United Concordia for details and limitations.|
|You must reside in the Maryland service area (DC, DE, MD, PA, VA) to be eligible for the DHMO plan. If you do not reside in the Maryland service area, you must select the DPPO plan in order to receive dental benefits.|
United Concordia will pay a maximum of $50 (difference between the dentist's charge and your copayment) for emergency dental services when you are traveling out of the area (more than 50 miles from your primary dental office). To receive payment for out-of-area emergency care, you must submit a claim form and receipted bill itemizing the charges and services performed to United Concordia for processing.
Financial Responsibility of Plan Member
Before you receive any services, be sure to consult the Concordia Plus Schedule of Benefits to ensure that you have anticipated all out-of-pocket costs and liabilities associated with a particular type of treatment. You are also encouraged to discuss major procedures and your financial liability with your dentist.