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Frequently Asked Questions -- Dental HMO

 

 

1

Q.

I understand I am required to select a dentist when I enroll. Who are these contracted dentists?

A.

Dentists who contract with SafeGuard must meet state regulations regarding office cleanliness, appointment availability, and proper oral treatment as well as SafeGuard-set standards. SafeGuard contracted dentists are pre-screened before being accepted into the network and must go through the process again every few years. By doing this, SafeGuard is able to provide you the quality service you deserve.

 

Q.

Do I have a waiting period on this plan?

A.

There is no waiting period. You may make an appointment with your selected general dentist on the day you become "effective". (Your Human Resources coordinator will be able to help you with your effective date.)

 

Q.

Do I need an ID card to receive services?

A.

SafeGuard will provide you with an ID card when you enroll, but it is good to note that an ID card is not necessary to receive services. Your selected general dentist receives a list every month of all SafeGuard members enrolled in his or her practice and they may also verify eligibility with us prior to your appointment.

 

If you would like a card, there is also a temporary ID card in the front of your enrollment kit, or you can print one from SafeGuard's interactive website.

 

Q.

What if I move or want to see a dentist near my work - can I change dentists?

A.

Changing dentists is easy. Check the online directory and choose a contracted dentist - remember to write down the "Facility #" for that dentist. Then there are two ways to make the change. You can change dentists on the interactive website or by using the IVR (Interactive Voice Recognition) telephone technology.

 

In most cases, your transfer will become effective on the first of the month following your request.

 

Q.

My children want to see a dentist near their school. Does everyone in my family have to go to the same dentist?

A.

SafeGuard's individual selection feature allows you and your dependents the opportunity to select different dentists.

 

 

Q.

My dentist says I need more than just a routine cleaning. What is a "routine cleaning"?

 

A.

A "routine cleaning" involves the removal of normal amounts of tartar build-up and the polishing of teeth to remove stains. Routine cleanings are provided to members who have had regular dental checkups and cleanings and who are taking reasonable care of their teeth at home.

 

To learn more about deep cleaning and periodontal health, read our "Why a Deep Cleaning?" educational brochure on the health topics web page provided on this site.

 

 

Q.

My dentist says I need a crown. What is a crown?

 

A.

A crown is a cap that covers and strengthens a tooth that has had a root canal or is damaged to the degree that it cannot be properly repaired with only a filling. They are also used to anchor dental bridges. Crowns can be made of metals, porcelain or porcelain fused to metal.

 

To learn more about crowns, read our "Confused About Crowns?" educational brochure on the health topics web page provided on this site.

 

 

Q.

Does my plan cover any cosmetic procedures?

 

A.

Your Nexus 150 plan includes many of the most popular cosmetic procedures available today. Bleaching, veneers, white fillings, and adult & child orthodontics (braces) are all included at very reasonable co-payments -- much lower than you would pay without your SafeGuard benefit plan.

 

Please refer to your Schedule of Benefits for complete information.

 

 

Q.

What if I need to see a specialist?

 

A.

Specialty care services are available only when the dental procedure cannot be performed by your selected general dentist due to the severity of the problem.

 

With the Nexus 150 plan, your general dentist will submit all required documentation to SafeGuard and SafeGuard will advise you of the name, address and telephone number of a SafeGuard contracted specialist in your area.

 

No pre-authorization is required for Orthodontic benefits. You may receive treatment from any SafeGuard contracted orthodontist.

 

 

Q.

What if I need emergency care?

 

A.

SafeGuard contracted dentists provide emergency dental services 24 hours a day, 7 days a week. If you are away from home and experience a dental emergency or cannot reach your general dentist, call SafeGuard and we will give you the name of a dentist near you who will provide treatment. If it is after business hours and you cannot reach our Customer Service Department, you may see any dentist for relief of pain and you will be reimbursed for the treatment. Please review your Evidence of Coverage or click here for more information.

 

 

Q.

Who can I contact if I have other questions?

 

A.

Your Human Resource Department can help you with questions specific to your organization's requirements. If you have any questions about the SafeGuard plan, you can contact our Customer Service Department at 800.880.1800 or you can email Customer Service at web.cust.serv@safeguard.net.