faqs

PPO Plan
Indemnity Plan
Enrollment
Claims
ID Cards
Customer Service

PPO Plan

  • In what states is the PPO plan available?

    • AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, MI, MN, MO, MS, NC, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WA, WI

  • What are the main features of the PPO plan?

    • Extensive network of qualified dentists
    • Substantial cost savings when visiting a network dentist
    • No claim forms to submit for in-network coverage
    • Flexibility to see a dentist outside the network and affordable preventive service coverage
    You may view summary plan descriptions from the Forms Download section of this Web site.

  • How do you select your network dentists?

    • Our dentists go through a strict credentialing process before they are allowed to join the network. The credentialing process involves verification of dentist education, licensure and liability claims history. Network dentists are re-credentialed every two years to ensure that the highest quality dentists participate with us.

  • Do I have to select a Primary Care Dentist?

    • No. With the PPO Plan, there is no need to select a primary care dentist. You have the choice of seeing any in-network or out-of-network dentist for your dental needs. Please refer to the Dentist Directory for a complete listing of both general dentists and specialists within the network. Check to see if your current dentist is participating-if not, you can continue to see your current dentist, although you will be reimbursed at a lower rate. You have the option to select a new, participating dentist and reduce your out-of-pocket expense and the hassle of claim forms.
    You may also find a participating dentist close to your home or office through our Dentist Locator at www.myuhcdental.com.

  • Do I need a referral to see a specialist?

    • No. You may see a specialist at any time without receiving approval from the dental plan. There is no difference in the percentage of benefits you receive when seeing a participating specialist rather than a participating general dentist. However, because specialists usually have higher fees, the cost of a specialist may result in higher out-of-pocket expenses for you. Also, please note that the percentage of benefits may be less if you choose a specialist that is not participating within the network.

  • How should I schedule an appointment?

    • Simply schedule an appointment with a dentist of your choice, either in or out of network. Let the dental office know you participate with the plan and show your dental ID card at the time of your appointment.

  • Who can I call with questions about my dental benefits?

    • If you have questions regarding coverage details, claims, or locating a dentist in your area, please contact the UnitedHealthcare Dental Customer Service Department. The department can be reached at 877-828-9230, Monday through Thursday 8:00 a.m. to 8:00 p.m., and Friday 9:00 a.m. to 8:00 p.m., Eastern Time.
    Through the same toll-free number, you may also choose to use the automated voice system. This provides access to dental information 24 hours a day, 7 days a week. Among many options, this system allows you to check the status of a claim.

  • Who can I call with questions about eligibility and premium billing?

    • If you have questions regarding your enrollment and/or premium payments, you may contact a service representative at 800-233-0438. Our representatives are available Monday through Thursday 8:30am to 5:30pm, and Friday 8:30am to 3:00pm, Eastern Time to assist you.

  • What is considered a dental emergency?

    • You are covered for dental emergencies and may contact any dentist to let them know you have a dental emergency. Participating dentists are required to see you within a 24-hour period if you experience one or more of these emergency symptoms:
    • Pain
    • Bleeding
    • Swelling
    • Fractured teeth or bones
    • Lost or fractured crown, bridge or filling
    • Facial trauma
    The following symptoms are not usually considered an emergency:
    • Broken denture or tooth
    • Dental cleaning
    • Post-operative discomfort within reason
    • Aesthetic changes of existing teeth or restoration

  • How does the annual deductible and coinsurance work?

    • If your plan includes an annual deductible, you must pay that yearly dollar amount before the plan will pay benefits on your behalf. After you have met your annual deductible, the plan will pay either a percentage of their network negotiated fees for in-network care, or a percentage of eligible reasonable and customary charges for out-of-network care. Reasonable and customary charges are determined by comparing similar dental services and their related expenses within the same geographic area.
    The percentage of dental charges you are responsible for paying at the time of service is called co-insurance. Since the PPO plan has negotiated discounted fees with participating dentists, it will cost you less if you receive your dental care within the dental network. The percentage of co-insurance does not change based on whether you see a participating general dentist or a participating specialist. The amount you pay varies based on the procedures performed and whether the dentist is participating in the network. Co-insurance must be paid at the time of service unless prior arrangements have been made between you and your dentist.

  • How does the annual plan maximum work?

    • The annual plan maximum benefit is the total amount that the plan pays for your treatment in a year. Each claim reimbursement accumulates towards your annual maximum. The plan will pay a total amount up to the highest maximum, not a combination of the in-network and out-of-network maximums. For example, if the in-network and out-of-network maximums are both $1,500, your annual maximum is $1,500, not $3,000.

  • Do I need to submit claims?

    • When you seek care from dentists who participate in the network, you do not need to file claim forms.
    If you use an out-of-network dentist, you must pay the dentist in full at the time of your visit and submit a completed claim form for reimbursement. To access a claim form see our Forms Download page.
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Indemnity Plan

  • In what states is the Indemnity Plan available?

    • AK, HI, ID, ME, MT, ND, SD, VT, WV, WY

  • What are the main features of the indemnity plan?

    • Freedom to see the dentist of your choice
    • No referral required for specialty care
    • Prompt, reliable claims reimbursement
    • Affordable preventive service coverage
    You may view summary plan descriptions from the "Forms Download" section of this Web site.

  • Do I need to select a Primary Care Dentist?

    • No. The Indemnity Plan offers you the freedom to choose any dentist. There is no network from which you must select a dentist. You can remain with your current dentist or go to a new dentist at any time.

  • Do I need a referral to see a specialist?

    • No. You can go directly to a dental specialist without the need for a referral from a general dentist for treatment. You can just select a specialist and go to your appointment.

  • How are my benefits determined?

    • Your benefits are based on reasonable and customary charges. Reasonable and customary charges are determined by comparing similar dental services and their related expenses within the same geographic area.

  • Who can I call with questions about my dental benefits?

    • If you have questions regarding coverage details, or claims, please contact the UnitedHealthcare Dental Customer Service Department. This department can be reached at 877-816-3596, Monday through Thursday 8:00 a.m. to 8:00 p.m., and Friday 9:00 a.m. to 8:00 p.m., Eastern Time.
    Through the same toll-free number, you may also choose to use the automated voice system. This provides access to dental information 24 hours a day, 7 days a week. Among many options, this system allows you to check the status of a claim.

  • Who can I call with questions about enrollment and premium billing?

    • If you have questions regarding your enrollment and/or premium payments, you may contact a service representative at 800-233-0438. Our representatives are available to assist you Monday through Thursday 8:30am to 5:30pm, and Friday 8:30am to 3:00pm, Eastern Time.

  • Do I need to submit claims?

    • Yes. You must pay your dentist in full at the time services are rendered. You will then need to submit a completed claim form for reimbursement. You may access a claims form on our Forms Download page.

  • How does the annual deductible and coinsurance work?

    • If your plan includes an annual deductible, you must pay that yearly dollar amount before the plan will pay benefits on your behalf. After you have met your annual deductible, the plan will pay a percentage of eligible reasonable and customary charges.
    If there is any remaining charge, you are responsible for paying the dentist that amount at the time of service. This is called coinsurance and the amount you pay depends on the amount your dentist charges for each procedure.

  • What is the annual plan maximum?

    • The annual plan maximum benefit is the total dollar amount that the plan pays for your treatment in a calendar year. Each claim reimbursement accumulates towards the annual maximum.
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Enrollment

  • Where do I send my completed Enrollment Form?

    • Once you have completed your Enrollment Form, you may send it to us by fax or mail.
       
      By fax:   214-252-0312
      By mail:   FEDERAL FIRST Service Center
    ATTN: Dental Plan
    P.O. Box 191029
    Dallas, TX 75219-1029
       
    PLEASE BE SURE to complete all information requested in order to avoid delays in processing your Enrollment. If you need any assistance, please contact us at 800-233-0438.

  • How do I pay for this coverage?

    • Premium payments for either the PPO or Indemnity plans may be made either through Monthly Billing or Automatic Bank Draft (ACH Payment).

  • When will my coverage become effective?

    • We must have your enrollment information and first month's premium payment by the 15th of the month in order to have a plan effective as of the 1st of the following month, or January 1, 2006, whichever is later.

  • What should I expect to receive once I have successfully enrolled?

    • Once we have processed your Enrollment Form, verified your eligibility, and received your first premium payment, you will receive a Welcome letter summarizing the enrollment selections you have made, your monthly premium, and what to expect next.

  • Where can I call to receive help completing my Enrollment Form?

    • For assistance with completing your Enrollment Form please contact us at:
        Phone: 800-233-0438
        Email: customerservice@federalfirst.com.

  • What legal documentation must I provide for my court ordered dependant(s)?

    • You should submit a copy of the Qualified Medical Child Support Order (QMCSO) with your application.
    If you have a court ordered dependent, your Enrollment Form cannot be processed until we receive a copy of the QMCSO.

  • Will my handicapped dependent who is older than 25 be covered?

    • In order to enroll your dependent in this situation, you will need to submit a statement from the dependent's attending physician attesting to the fact that this dependent is disabled and is chiefly dependent on you for support and maintenance. This documentation should be submitted with your Enrollment Form.
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Claims

  • Where do I send my completed claim form?

    • If you are required to submit a claim form, please send your completed forms by mail to:
      UnitedHealthcare Dental
    Attn: Claims Unit
    P.O. Box 30567
    Salt Lake City, UT 84130-0567

  • Do I need to submit claims if I am in an Indemnity Plan?

    • Yes. You must pay your dentist in full at the time services are rendered. You will then need to submit a completed claim form for reimbursement.

  • Do I need to submit claims if I am in a PPO Plan?

    • When you seek care from dentists who participate in the network, you will not need to file any claims. If you use an out-of-network dentist, you must pay the dentist in full at the time of your visit and submit a completed claim form for reimbursement.

  • Where can I get a claim form to complete?

    • You may download a claim form from the Forms Download section of our Web site or phone 877-816-3596 to request a form.

  • Can I access my claim information online?

    • Yes. You may either click the "My Benefit" menu item, or type www.myuhcdental.com into your browser's address line. If you are currently enrolled, you will need to register a user ID and password to access to your personal eligibility and claim information.
    Visit the Forms Download section of this site to view and print step-by-step instructions for the registration process to access your account.
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ID Cards

  • When will I receive a Dental ID card?

    • Your Dental ID card will arrive in the mail approximately 10 business days after your benefit effective date is documented on our system. Cards are mailed only to the address you provide during the enrollment process.

  • How many ID cards will I receive?

    • You will receive one ID card if you have selected subscriber-only coverage. You will receive a maximum of two cards if you have any covered dependents. You may request additional ID cards as needed.

  • How can I request additional or replacement ID cards?

    • There are several ways you can request additional ID cards:
    • Contact Customer Service at 877-816-3596, Monday through Thursday 8:00 a.m. to 8:00 p.m., and Friday 9:00 a.m. to 8:00 p.m., Eastern Time. A service representative will order a card for you, which will arrive approximately 10 days later.
    • Through the same toll-free number, you may also choose to use the automated voice system. This provides access to dental information 24 hours a day, 7 days a week. Among many options, this system allows you to order another ID card.
    • You may register on the dental web site with a user ID and password and have access to your personal eligibility and claim information, as well as request additional ID cards. You may either click the "My Benefit" menu item, or type www.myuhcdental.com into your browser's address line. Visit the Forms Download section of this site to view and print step-by-step instructions for the registration process to access your account.

  • Can I get an ID card with my name on it?

    • ID cards are not member-specific. The Dental ID cards will only display the subscriber's name and ID number. All dependent coverage is assumed under this ID number, so this card is appropriate for all covered family members.

  • I have enrolled in the plan but not yet received my ID card, and now I have to see a dentist right away. What should I do?

    • If you have enrolled and your coverage has begun, but need services before receiving your Dental ID card, you may take a copy of the Dental eligibility letter with you to your appointment. This letter has all the information that would be on your ID card to enable your dentist or specialist to update their insurance and billing information.
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Customer Service

  • My member benefit card lists two toll-free contact numbers; what's the difference?

    • Contact us at 800-233-0438 if you have questions regarding:
    • Completing your Enrollment Form for initial coverage selection
    • Completing your Enrollment Change Form for coverage selection changes
    • Making premium payments and completing ACH Authorization Forms
    • Changing your address or your name
    Contact us at 877-816-3596 if you have questions regarding:
    • Specifics of your plan coverage (what is covered, what is not)
    • Claims, both general and specific or to check on the status of your claim
    • Dental provider information

  • How do I change my address?

    • To change your address, please send your previous and current address information to via fax or email.
        Fax: 214-252-0312
        Email: customerservice@federalfirst.com

  • How do I notify you that my name has changed?

    • To change your name, you may fax or mail an Enrollment Form with the "Change" box checked (upper right corner) and complete the personal information section.
    You must attach one of the following documents to support your name change:
    • Marriage Certificate or Divorce Decree
    • Court Order
    • Valid State Driver's License
    Fax: 214-252-0312
    Mail: FEDERAL FIRST Service Center
    Attn: Dental Plan
    P.O. Box 191029
    Dallas, TX 75219-1029

  • How do I change the account my premium is withdrawn from?

    • To change your bank account you will need to complete a new ACH Authorization Form and return to us along with a voided check for the new account. You may download a new form from our Forms Download page or contact us at 800-233-0438 to have a new ACH Authorization Form mailed to you.
    You may also request an ACH Authorization Form by sending emailing us at customerservice@federalfirst.com.

  • Where do I call to get information about my benefits?

    • For benefits and claims information, please call Customer Service at 877-816-3596.

  • Where do I send my completed claim form?

    • If you are required to submit a claim form, please submit your completed forms to:
      UnitedHealthcare Dental
    Attn: Claims Unit
    P.O. Box 30567
    Salt Lake City, UT 84130-0567

  • Where can I get a claim form to complete?

    • You may download a claim form from the Forms Download section of our website or contact us at 877-816-3596 to have a form mailed to you.

  • Can I access my benefit and claim information online?

    • Yes. If you are a currently enrolled member, you can register with a user ID and password and have access to your personal eligibility and claim information. You may either click the "My Benefit" menu item, or type www.myuhcdental.com
    Visit the Forms Download section of this site to view and print step-by-step instructions for registering to access your account.

  • How do I change my plan and/or coverage option?

    • Changes to your plan and coverage options may be made by completing an Enrollment Form and indicating "Change" in the upper right box. Complete your personal information and indicate the changes you wish to make.
    Plan and/or coverage changes may only be made during your Chapter's designated Annual Open Enrollment period.

  • When may I make plan and/or coverage changes?

    • You are only permitted to make plan and coverage changes during your Chapter's designated annual open enrollment period unless you experience a "Life Event". A "Life Event" occurs in the following situation:
    • Marriage or Divorce - your change form must be accompanied by a copy of your Marriage license or Divorce decree.
    • Birth of a child
    • Adoption of a child
    • Death in family
    Your change request must be received within 31 days of the event. Please call 800-233-0438 for more information
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