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Frequently Asked Questions

 

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You may have questions about the dental benefit program Pasco County Schools is providing through SafeGuard. Here are answers to the most frequently asked questions members have about their SafeGuard plans.

 

Answers To Your Dental HMO Questions

Answers To Your Dental PPO Questions

Answers To Your Dental HMO Questions
 
 

Q.

Do I need to select a general dentist when I enroll?

A.

Yes. The SafeGuard general dentist you select at enrollment will provide your routine dental care…and with SafeGuard’s individual selection feature, you and your enrolled dependents can each select different network dentists.

 

Q.

Who are the dentists in your network?

A.

SafeGuard contracts with both private practice dentists and those who are in a clinic environment. Every dentist in our network has been thoroughly screened prior to acceptance and we report regularly to the State of Florida with regard to the quality of care within our network. SafeGuard is also subject to regular audits both in our offices and in the dental practices. You are protected when you enroll in a SafeGuard plan.

 

A list of providers in your area can be found on the SafeGuard website at www.safeguard.net.

 

Q.

Can I change dentists?

A.

Yes. Call us or use SafeGuard’s interactive web site to change dentists. Your transfer will be effective the first of the following month.

 

Q.

What if I need emergency care?

A.

All SafeGuard general dental offices provide emergency access 24 hours a day, 7 days a week. If you cannot reach your selected general dentist, you may receive emergency care from any licensed dental care professional. (The definition of what is considered “emergency care” can be found in your Evidence of Coverage booklet located on the “Your Benefits” page of this site or on the Pasco Employee Benefits Department website*). Or you may go to SafeGuard’s Member website (www.safeguard.net) for Florida-specific emergency information.

 

*http://ebarm.Pasco.k12.fl.us.

 

Q.

My child is currently in orthodontic treatment. If I enroll in the dental HMO plan, will we have to change orthodontists?

A.

If you are currently enrolled in the School Board’s DHMO plan, there’s a good chance your current orthodontist is already part of SafeGuard’s network. If so, we can negotiate a transition for you if you submit a “Continuing Orthodontic Treatment Request Form” at enrollment. If your orthodontist is not currently a member of SafeGuard’s network, submit the form in the same way. We will work to ensure that your doctor is able to continue your current treatment program. (For the necessary form, contact your Human Resources Representative.) If you are currently enrolled in the PPO dental plan, we would not be able to move your ortho treatment to the DHMO plan.

 
 

Q.

I noticed some dental offices in your directory appear to be closed to new members. What if one of them is my current dentist?

 

A.

That’s why we list all network dentists, not just the offices that are open to new membership. If you are currently a patient in one of those offices, you will not have to change dentists since you are not really considered a “new” patient.

 
 

Q.

What if I need to see a specialist?

 

A.

This is a “direct referral” plan which means your SafeGuard general dentist will refer you to a contracted specialist in your area.

 
 

Q.

Do these plans cover second opinions?

 

A.

Absolutely. Just let us know that you would like another clinical opinion and we will provide the name of a dentist for you to see.

 

 

Answers To Your Dental PPO Questions

 
 

Q.

How does this plan work?

A.

This plan has a calendar year maximum of $1500, which is the maximum amount SafeGuard will pay toward the dental care for each person enrolled on this plan. There is a yearly deductible of $75 per person up to 3 - $225 a year deductible is all you will pay per family. There is a “coinsurance percentage” for each type of procedure covered which is the percentage SafeGuard pays, after deductible, if applicable.

 

Your Summary of Benefits provides more information – a copy is included on this site’s “Your Benefits” page… or you can find it on the Pasco Employee Benefits Department website. (*http://ebarm.Pasco.k12.fl.us)

 

Q.

Do I select a dentist when I enroll?

A.

There is no requirement to “pre-select” a dentist. You will save money by receiving care from a SafeGuard contracted dentist and a directory for your area is available on the SafeGuard website – a link is available on the Pasco Employee Benefits Department website. You can search by name, city, county or zip code – use the “Visitor” access prior to enrolling.

 

Q.

What if I have other dental coverage in addition to the SafeGuard plan?

A.

We will coordinate our benefits with those you may be entitled to from other policies. Your combined benefits may pay up to, but no more, than the total covered expense.

 

Q.

What’s the difference between in and out-of-network benefits?

A.

With this plan, you can receive care from any licensed dental care professional…but if you see a contracted SafeGuard dentist, you will reduce your out-of-pocket costs. These network dentists have agreed to reduce their treatment fees up to 30% for SafeGuard enrollees. In addition, your reimbursement percentage will be higher in-network…you will save two ways! And, you won’t have to do any paperwork – your SafeGuard dentist will file your claims for you.

 

Q.

Do I need to get approval on some costs before treatment starts?

A.

Approval of benefits is not required but we do encourage you to have your dentist submit a preauthorization request for a treatment plan of more than $300. This will ensure that any of the procedures suggested are, in fact, covered benefits. It also gives you a chance to find out beforehand what the out-of-pocket expenses will be.

 
 

Q.

How do I file a claim?

 

A.

In most instances, your dentist’s office staff will ask you to sign an “assignment” form that allows them to file the claim for you and pay them directly. Both you and your dentist will receive an Explanation of Benefits that details how the claim was paid.

 

If your out-of-network dentist prefers that you pay first and file your own claim, complete a standard claim form and submit it to: SafeGuard – PO Box 30930 – Laguna Hills, CA 92656-0930.