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How do I know if my dentist is a network dentist?
When you enroll in DeltaCare USA (dental HMO), you select a network dentist from the list of DeltaCare USA (dental HMO) network dentists.
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My dentist is a Delta Dental dentist but is not on the list of DeltaCare USA (dental HMO) dentists. Can I still receive treatment from this dentist?
You must receive treatment from your selected DeltaCare USA (dental HMO) network dentist. Please note that Delta Dental dentists are not necessarily DeltaCare USA (dental HMO) dentists.
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Do my family members receive treatment from the same DeltaCare USA (dental HMO) network dentist?
You and your eligible dependents may receive care from the same network dentist, or if you prefer, you may select individual contract dental facilities.
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Can I change my network dentist?
You may change network dentists by notifying us either by phone or in writing, or by visiting our web site. If you contact us by the 21st of the month, the change will be effective the first of the following month.
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How do I know DeltaCare USA (dental HMO) dentists provide quality care?
DeltaCare USA (dental HMO) dentists are reviewed for quality, availability and safety before joining the network, as well as periodically thereafter.
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How long does it take to get an appointment with a DeltaCare USA (dental HMO) dentist?
Two to four weeks is a reasonable amount of time to wait for a routine, non-urgent appointment. If you require a specific time, you many have to wait longer. In addition, most DeltaCare USA (dental HMO) dentists are in private group practices, which means greater appointment availability and extended office hours.
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How does the DeltaCare USA (dental HMO) program encourage preventive care?
Your DeltaCare USA (dental HMO) program is designed to encourage regular visits to the dentist by having no copayments (amounts you pay to the network dentist) on most diagnostic and preventive benefits. See your "Description of Benefits and Copayments" for details.
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Are pre-existing dental conditions and work in progress covered?
Treatment for pre-existing conditions such as extracted teeth is covered under the DeltaCare USA (dental HMO) program. However, benefits are not provided for any dental treatment started before joining the program (that is, work in progress, such as preparations for crowns, root canals and impressions for dentures). Orthodontic treatment in progress may be covered for new DeltaCare USA (dental HMO) enrollees. See the "Limitations and Exclusions of Benefits."
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Does my DeltaCare USA (dental HMO) program cover specialists' services?
Your network dentist will coordinate your specialty care needs for oral surgery, endodontics, periodontics or pediatric dentistry with an approved contract specialist. There is no additional charge for receiving care from a specialist. If there is no contract specialist within your service area,a referral to an out-of-network specialist will be authorized at no extra cost, other than the applicable copayment.
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Does my DeltaCare USA (dental HMO) program cover tooth-colored fillings and crowns?
Porcelain and other tooth-colored materials are included as a benefit under your Program. The copayment shows what your out-of-pocket cost will be.
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Can I have my teeth whitened under the DeltaCare USA (dental HMO) program?
External bleaching is a benefit under your Program. See the "Description of Benefits and Copayments" and talk to your network dentist about your options.
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What if I have questions about my DeltaCare USA (dental HMO) program?
Call customer service at (800-422-4234). We have multilingual representatives available from 5 a.m. to 6 p.m. Pacific time, Monday through Friday. Our Customer Service representatives have worked in dental facilities and can answer benefits questions, as well as arrange facility transfers and urgent care referrals.
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