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2010 Dental Plan
Information |
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Toll-free Customer
Service Number: |
| 1-888-638-3384 |
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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 provider. | | 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 Enrollment Form, 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 through non-United Concordia DHMO providers. Please call United Concordia for details and limitations, or if you are transitioning from a dental plan that is no longer offered. | | If you reside in an area that does not have a United Concordia network of DHMO dentists, you must select the PPO plan in order to receive dental benefits. |
Out-of-Area Emergencies
United Concordia Companies, Inc. will pay up to a maximum of $50, subject to 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 Companies, Inc. 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.
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