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Frequently Asked Questions

The following are several questions commonly asked by our members regarding their benefits. We hope that these answers will help you get the most out of your dental benefits.

PPO/INDEMNITY DENTAL PLAN

1. What is my deductible?

Your deductible will vary depending on whether of not you choose to use a participating PPO Provider. When using the in-network PPO dentist you will have a $25 calendar year deductible (maximum $75 per family) when using the out-of-network dentist you will have a $50 calendar year deductible (maximum $150 per family. )

2. What is my maximum benefit?

The maximum reimburse bale is $1,250.

3. Who submits my claim - me or my dentist?

It is your responsibility to ensure that claims are filed. However, some dental offices will be happy to assist you with filing a claim.

4. Who gets paid - me or my dentist?

You will want to discuss this with your dentist before he or she provides services. Reimbursement will be determined by "assigning" benefits at the time your claim form is completed.

Your dentist may want you to pay him or her directly, and then you would be reimbursed, or your dentist may prefer the insurance company pay your claim directly to the dentist.

5. How are benefits coordinated if I am covered under more than one policy?

If you have coverage with two insurance companies, you may want to file a claim with both companies. One company will be considered "primary" and thus will pay benefits first. The other company will be considered "secondary" and will pay its benefits only after the "primary" company has done so. The total of the benefits paid by the two companies will not exceed your actual costs.

6. How do I obtain a claim form?

Some dental offices may have claim forms, some may not. If neither your dental office nor your Insurance Benefits office has claim forms, CompBenefits will be happy to supply you with one.

Please call 1-866-890-4464 and 954-527-4088.

7. How long do I have to file a claim?

All claims are to be filed within one (1) year of the date of service.

8. Can I go to any dentist?

Your policy allows you to visit the dentist of your choice. Remember, you will receive enhanced benefits when utilizing a PPO Participating Provider. Please refer to your Schedule of Benefits for more details.

9. Is there orthodontic coverage on my plan?

There is no orthondontic.

If you have questions about any of the four plans . . .

Please call American Dental Plan's Member Service Hotline at 1-866-890-4464 or 954-527-4088.

 

 

 

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