Plan Details

See what makes your dental plan tick

 

We know any insurance plan tends to be a little confusing. That’s why we provide information on many common questions members have about their dental plans.

 

View your personal benefits information online

Any time you want to see your personal benefits information, such as who is covered under your plan and the status of your claims, just sign in to My Dental Benefits.

 

How does my plan work?

If you have coverage through your employer, you chose from the plans your employer offered. This could be either a Dental Health Maintenance Organization (DHMO) or Preferred Provider Organization (PPO) plan.

 

What PPO plans offer

  • Broad range of covered services
  • Typically includes a coinsurance for many services (you pay a percentage of the cost of the service)
  • Often no coinsurance for preventive care
  • Usually there is a maximum amount your plan will pay annually
  • Most plans have deductibles that each member must pay before the plan will begin to pay
  • You can visit any dentist, but save more by visiting a network dentist 

 

What DHMO plans offer

  • Many covered services, focused on preventive care
  • Typically a member pays a copayment amount per service
  • Most plans have no copayments for preventive care
  • No maximums or deductibles
  • You must visit a Concordia Plus general dentist to receive coverage
  • Your general dentist will refer to you a specialist if necessary

 

What if I have the iDental Discount plan?

This plan is not insurance, but does provide savings on dental care.

 

What happens if I visit a non-network dentist?

If you have a PPO plan, then your benefits will apply, but you may have to pay the difference between the fees our network dentists have agreed to accept and the non-network dentist’s full fees. Also, you will need to pay any coinsurances or deductibles that apply (just like you would at a network dentist).

If you have a DHMO or the iDental Discount plan, you will not have coverage for any services received from a non-network dentist. That means you would be responsible for the entire cost of the service.

 

How do I nominate my dentist for participation in my network?

If your dentist is not currently participating in your network, you can nominate your dentist by completing our online dentist nomination form. Your dentist may also contact us directly at 1-800-332-0366 from 8 a.m. to 8 p.m. ET.

 

Do I need an ID card?

For PPO and DHMO plans, you don’t need to show an ID card to receive services—you can just tell your dentist you are a United Concordia member. But, presenting your ID card might be helpful to make sure your dentist has the correct information for your dental plan. In fact, if you have a unique member ID or client-assigned ID number (an ID that isn’t your Social Security number) we suggest that you present your ID card at the dentist.

 

Want to print an ID card?

You can print one anytime –just sign in to My Dental Benefits.

For the iDental discount plan, you will need to show your discount card to your dentist to receive a discount on services. This card is sent to you in the mail after you sign up for your plan.

 

Predetermination of benefits

If you expect your dental service to cost more than $500, it might be wise to ask your dentist to submit a predetermination of benefits to us to calculate how much of your dental services will be covered. This allows you to know up front what you can expect to pay out of pocket.

 

Canceling a plan

If you have coverage through your employer, your plan covers you for one year, after which you must enroll again. If you no longer wish to be covered under your employer’s dental plan, simply do not re-enroll for the next year.

 

Other resources

How to read an Explanation of Benefits (EOB)

Get state-specific rules about your plan

Contact customer service

Download claim forms