Q:Do I
have a yearly spending Cap-Off amount?
A:No...You may see a
dentist as much as needed “as long as you keep your policy in force.”
Q: Can I sign up if I'm over the age of 65?
A:Yes...There are no age
limits, anyone can take advantage of the NA245D Plan.
Q: Are there any deductibles?
A:No...You pay set
co-pay amounts for your primary dentist's services which will vary depending on
your procedures.
Q: Is there a Contract?
A:Yes...There is a
6 month agreement giving you enough time to get your dental services completed.
This will also allow adequate time for the dental office to submit you're
claims, thereby ensuring coverage.
Q: Is there a waiting period before I can see the
dentist?
A:No...Your policy becomes effective on the 1st of
the following month from the date you applied.
Q: Can my child over the age of 21 be on my policy?
A:Yes...Children
may continue on your policy until they reach the age of 25. From the age of 25,
they are required to have their own policy, unless they are mentally or physically
disabled. In that case, you must submit proper documentation showing such
circumstances.
Q: Is there a limit to the number of dependents I am
able to put on my policy?
A:No... You may put as many dependents on your plan
as needed as long as they qualify as a dependent. In certain situations, you
may add other members to your policy if you are a legal caretaker of that
person.
Q: Do I have to be married to add my spouse?
A:No...It can be a boyfriend/girlfriend situation or
even a same sex situation as long as you both reside together.
Q: Do I have to stay with one dentist or can I
change?
A:You may change your primary dentist every month if
you choose to do so, giving you the opportunity to find a provider that you are
comfortable seeing.
Q: Can I see any dentist I want?
A:No...You must see one of our in network providers
who are contracted to honor the set co-pay prices. This will protect you as a
consumer from being over charged.
Q: Are specialists covered?
A:Yes...You may see a specialist under this plan at a
25% discount, however you must be referred to one by your primary dentistbeforesetting an appointment.
Q: Can this Plan be used with other Dental Plans?
A:Yes..As long as you are using the NOP Dental
Program as yourPrimaryPlan in conjunction with
an Indemnity Plan, you may submit your paid receipts to your secondary
Indemnity Plan for reimbursement.
Q: Do I need to be issued a Benefit Card before
seeing a Dentist?
A:No...It takes 2-4 business weeks to receive your
Benefit Cards from the time of enrollment, but you may see your selected
primary dentist if an appointment is scheduledafterthe 7th of
the effective month of your policy.
Q: How do I find a primary Dentist in my area?
A:The individual who signed you up can help you find a
dentist. Also you will receive a
Directory of Participating Dentists with your Benefit Cards.
Q: Can I add Dependents at a later time?
A:Yes...You may add Dependents at anytime to your
effective policy without any additional enrollment fees, but your premiumwillincrease to reflect the additional person/people
added “on your selected draft date” for the following month.
Q: Are there open Enrollment Periods?
A:You may enroll at anytime throughout the year, as
long as it is done by theend of the month cut off date.
Q: What will happen after my 6 month enrollment period?
A:After your 6 month initial period has passed, your
policy will remain in effect as long as you choose. It will not automatically
cancel out. Your savings on your maintenance (cleanings, x-rays, etc...) will
cover most of your Premium cost per year.
Q: How am I billed for these benefits?
A:The plan only accepts EFT payments set up
through your bank (checking, savings, debit) or credit card on a recurring
basis.
Q: If you don't want to give out your banking
information or credit card information there is another option:
A:You may pay an annual premium plus the $55.00 Group
Enrollment Fee (one time only).
Q: What is the difference between adental
discount planand adental HMO plan?
A:Dental discount plans vary greatly in “supposed”
savings. Dental HMOs have a predetermined co-pay for every procedure that you
will know in advance. Dental HMOs provide “Big Savings”. (Ex. Crown: Usual Fees
$900 - $1000. HMO co-pay $245 co-pay plus a $150 lab fee, total cost $395.
That's “Big Savings”!)
Q: How is it that individuals can get this group dental coverage?
A:Thisgroupwas formed by anon-profit
organizationwith the goal of providing benefits for its group members
that could not be obtained on an individual basis.
Q: Are pre-existing conditions covered?
A:Yes