DHMO Questions and Answers

How to use dental benefits:

You can search the list of Select Panel Providers using the Provider Map pages. You may call the CompBenefits Member Services Department at 1-800-432-3376 to verify your dentist's continued participation in your selected plan.

How can I make an appointment with my CompBenefits dentist?

You may schedule an appointment by calling the dental office you selected on or after your effective date of coverage. When you call to schedule your appointment, inform the office that you are a member of the CompBenefits dental plan. It will not be necessary to use any claim forms. If you need to cancel your appointment for any reason please let your provider know twenty-four (24) hours in advance of your scheduled appointment. The Benefits Schedule allows the provider to charge a fee (up to a maximum of $40) for any broken or cancelled appointment without twenty-four (24) hours notice.

Who is an eligible dependent for this coverage?

Eligible dependents for this plan include:

Spouse/Domestic Partner
Unmarried natural children, adopted children, and stepchildren under you or your spouse's legal guardianship until the end of the month in which the child reaches age 19
Children of a Domestic Partner, as long as the Domestic Partner is also covered.

Note:
Children may be covered under this plan until the end of the calendar year in which the child reaches age 25, provided he/she is unmarried and resides in your home and depends upon you for support, or is registered as a full-time or part-time student. Children with a mental or physical handicap are also eligible for coverage beyond the age of 19.

What should I do if I wish to change my selection of dentist?

You may change your dental office selection once a month. To change dental offices, call the CompBenefits Member Services Department at 1-800-432-3376. You will be transferred to the new dental office effective the first of the following month if notice is given prior to the 20th of the month. Transfers can only be processed if you have no balance due or pending appointments at your dental office.

What if I need the services of a Specialist?

There are certain procedures that are beyond the scope and competency level of a General Dentist and may require the services of a Specialist. To receive the services of a Specialist, you will be referred to CompBenefits participating Specialist (where available). The co-payments listed on your Schedule of Benefits will apply at the participating Specialist's office. If you have questions regarding referrals, please call the CompBenefits Member Services Department at 1-800-432-3376.

What can I do if I have questions about the treatment plan prescribed by my General Dentist?

You may contact the CompBenefits Member Services Department to make arrangements for a Second Opinion for a $15 fee. Second Opinions will not be covered if they are from a non-participating dentist or if arrangements are made on your own.

What if I'm currently seeing a dentist under one plan and I change plans to CompBenefits, but would like to maintain the same dentist?

As long as the dentist is part of the CompBenefits (OHS) network and is accepting patients, you may select the facility as your primary dentist. If the facility is not open to new membership, you will have to obtain approval from the dental office and contact CompBenefits prior to your assignment.

How can I receive Emergency Care within the service area?

If you require emergency care, first contact your General Dentist for an emergency appointment. If you cannot reach your General Dentist, contact the CompBenefits Member Services Department at 1-800-432-3376 for assistance. Arrangements will be made at the closest available office to receive emergency treatment.

How can I receive Emergency Care outside of the service area?

If you require emergency care and are temporarily one hundred (100) miles or more from your participating dental office, contact any licensed General Dentist to receive emergency treatment (relief of pain, bleeding or swelling). Pay for the services rendered and submit the receipt to CompBenefits with your name, social security number, address, phone number and your employer's name. CompBenefits will reimburse up to $100, less applicable co- payments. Please refer to Exclusions/Limitations for more information.

Where may I call for inquiries or additional questions?

All inquiries and questions should be directed to the CompBenefits Member Services Department at Miami-Dade: (305) 262-7329 or toll-free: 1-800-432-3376. Representatives are available Monday through Friday, 8 a.m. to 6 p.m.

Upon request, CompBenefits shall provide written information about the terms and conditions of the plan to prospective enrollees.

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