Must family members go to the same dentist? No. United Concordia allows each family member to select a different participating primary dental office.
Can I change my primary dental office? United Concordia allows members to change primary dental offices at any time. Changes made prior to the 15th of the month are effective the 1st of the following month. Members must call United Concordia and change their primary dental office prior to seeking services from the new office.
If I change my primary dental office, when is the change effective? United Concordia allows members to change primary dental offices at any time. Changes made prior to the 15th of the month allow the member to be seen at the new primary dental office the 1st of the following month. Members must call United Concordia and change their primary dental office prior to seeking services from the new office.
How can I obtain a directory of in-network DHMO dentists? Either call 1-888-638-3384 search online for a DHMO general dentist or a DHMO specialist.
Are there any benefit maximums? Under the United Concordia DHMO plan, there are no dollar limits when care is received from your primary dental office.
How often can I receive exams and cleanings? Exams and cleanings are covered at a frequency of 2 within a consecutive 12-month period. For example, if you currently have no history of a cleaning and you receive a cleaning on October 4 of this year, you will be eligible for a 2nd cleaning any time during the next 12 months (October 4, 2012—October 4, 2013). However, you will not be eligible for a 3rd cleaning until after October 4 of 2013.
Do I have to fill out a claim form after each routine visit? Under the United Concordia DHMO plan, there are no claim forms to worry about. (To receive payment for out-of-area emergency care, submission of a claim form is necessary.)
Are orthodontic benefits available? Orthodontic benefits are available to children and adults under the United Concordia DHMO plan. DHMO members must obtain a referral from their primary dental office to see a participating specialist for orthodontic services. The United Concordia DHMO plan does not cover services for orthodontic work in progress. Call 1-888-638-3384 for details and limitations.
How do I obtain care from a specialist? When specialty care is required, your primary dental office will refer you to a participating specialist. Self-referrals or any care received from a nonparticipating specialist are not covered under your DHMO plan.
Are there any procedures that are not covered? Yes, if a procedure is not listed on the Schedule of Benefits, it is not covered. Please see the DHMO Exclusions and Limitations for additional information.