Commonly Asked Questions

 

How often do I need a dental exam?
Unless otherwise directed by your doctor, it is recommended that you visit your dentist twice a year for a dental exam.

Who can I call for assistance?
Customer Care is responsible for all phone inquiries including eligibility, benefits, ID card requests, updating information and addressing claims issues. To contact, please call 800-999-9789 Monday through Friday 7:00 a.m. to 6:00 p.m. (Mountain Time).

When can I change or cancel my plan, including adding or deleting dependents?
You may make changes to or cancel your plan during your group’s open enrollment, or if there is a qualifying event such as: marriage, divorce or legal separation, birth of a child, loss of employment, new employment, or death of insured.

How do I find and choose a dentist?
Click here to search a map of dentists in your area. You can also search for a dentist using our mobile app . Keep in mind that you can choose and change your dentist at any time.

How soon will I get my ID cards?
ID cards will be mailed to either the member or employer, as specified, and will arrive approximately 7 – 10 working days from the time Dental Select receives the enrollment or change form. If you lose your ID cards, they can also be accessed through the Dental Select mobile app or by logging into the member web portal.

When can I start using my benefits?
After your effective date, new hire or other applicable waiting periods, you may begin using your benefits. If you are unsure, you can verify eligibility with a Customer Care representative at any time.

What services are included in my deductible?
Basic and Major services apply. Preventive services are not typically included in your deductible.

Can I choose to see a specialist rather than a general practitioner?
Yes. Services rendered by a contracting specialist will be reimbursed as follows: after the deductible, we pay the contracting specialist according to the contracted fee schedule as payment in full. Use of a contracting provider does not guarantee that all charges will be covered under the Policy. All charges are subject to all terms and conditions of the Policy.

Key Terms

 

Annual Maximum (Max): A maximum dollar amount that a plan will pay towards costs incurred by an individual during the 12-month benefit period.

Claim Form: A standard form most commonly submitted by the dentist that requests a payment of benefits for services provided. Claim forms are also used when requesting a pre-determination of benefits.

Co-insurance: The subscriber’s share of costs for services, usually figured as a percentage of the total charge.

Co-pay: The fixed dollar amount required at the time service is rendered. Deductible: A portion of dental care expenses that must be paid by an individual before their dental plan pays benefits.

Dependent: A child or person for whom another person such as a parent or relative may claim a personal exemption tax deduction. A dependent is a member but not the subscriber on the plan.

Effective Date: The date insurance coverage starts.

Eligible Dependent: A dependent of an insured person who is eligible for dental coverage.

Eligible Employee: An employee who is eligible for benefit coverage, based on the requirements of their employer’s dental plan.

Fee Schedule: A list of set fees that are updated annually, are not contingent upon individual conditions and do not vary within that year. Contracted dentists have agreed to use Dental Select’s fee schedules with discounted rates.

Member: Any individual enrolled and covered by a Dental Select plan. Both the subscriber and the dependent are considered members.

Member ID: A unique number assigned to identify an individual covered by a Dental Select plan.

Open Enrollment: The period of time when eligible employees and their dependents can enroll or make changes to their Dental Select plan.

Reasonable and Customary (a.k.a. R&C or UCR): Dental Select claims payments for non-contracted dentists are limited to R&C amounts.
R&C amounts are determined using a combination of national data and historical submitted claims data from dentists.

Subscriber (a.k.a. employee): The person whose employment makes him or her eligible for group dental benefits. All others enrolled on the plan are dependents.

Waiting Period: The time that must pass before some of your benefits can begin.