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 INDIVIDUAL
DENTAL PLANS
Who is eligible for individual dental coverage?
We offer coverage to California residents only. Anybody can obtain individual
coverage. Single people, families, students, retirees and unemployed people
are all eligible for coverage. Most plans do not have age limitations
or restrictions regarding pre-existing conditions.
What kinds of plans are available?
- DHMO (Dental Health Maintenance Organization) type plans require
you to use participating dental offices. They are very affordable and
usually do not have waiting periods before services are covered.
- Insured/Indemnity plans allow you to use ANY dentist, but are
more expensive and have waiting periods of up to eighteen months before
major services are covered. Major services include, but are not limited
to: crowns and bridges, dentures, periodontics, root canals and oral
surgery.
Why isn't my dentist listed on any of the
DHMO plans?
Dentists who participate in DHMO plans have agreed to charge members of
those plans the reduced fees you see listed in the brochures. Only a small
percentage of dentists are willing to accept these reduced fees. Some
of the plans pay the dentist a percentage of the premium cost (capitation)
to help offset the reduced fees that the dentists are accepting.
When will my coverage start?
DHMO Plans: Your application must be received in our office by the 15th for your coverage to start the first of the following month.
INSURED Plans: Your application must be received in our office by the 25th for your coverage to start the first of the following month.
Do you charge for your services?
No. The way we earn our living is from the commission the carriers pay
us when people enroll through our office. Using our service does NOT cost you
anything. You will pay the same premium amount, whether you enroll through
our site or any other place. We hope you appreciate the information we
have provided to you and will compensate us by entering our code number
for the appropriate plan on the enrollment form (if it has not already
been entered). In addition to the information you have already received,
we also provide service to our clients after the sale. Should you run
into any problems with the plan after you are enrolled, we will act as
your advocate with the carrier and assist you in resolving the problem.
Please enter our Agent code numbers if you enroll on-line:
SmileSaver: 19893
DeltaCare USA:2421
What if I need the coverage to start right
away?
You can get coverage usually within one business day (24 hours) under
a DHMO plan for a $10 fee. If you are interested in this option, please
call us at 800-848-2332, for details.
How do I get a brochure?
BY SNAIL MAIL:
Complete the brochure request form and we will mail brochures to you
right away.
BY FAX:
Complete the brochure request form and we will fax the brochures to
you right away.
DOWNLOAD OR VIEW ON-LINE:
You can download brochures from the Individual Plan page, Request a Brochure.
Where do I mail the application forms?
Dental Insurance Services, Inc.
P.O. Box 5437
Petaluma, CA 94955-5437
How do I enroll on-line?
Unfortunately, most of the carriers are not yet offering on-line enrollment.
If you have selected a plan that offers on-line enrollment, that information
will be provided to you when you request a brochure. If you do enroll
on-line, please enter our Agent Code number for the appropriate plan.
SmileSaver: 19893
DeltaCare USA:2421
What do I enter when the enrollment form asks
for an agent code?
The way we earn our living is from the commission the carriers pay us
when people enroll through our office. Using our service does NOT cost you anything.
You will pay the same premium amount, whether you enroll through our site
or any other place. We hope you appreciate the information we have provided
to you and will compensate us by entering our code number for the appropriate
plan on the enrollment form (if it has not already been entered). In addition
to the information you have already received, we also provide service
to our clients after the sale. Should you run into any problems with the
plan after you are enrolled, we will act as your advocate with the carrier
and assist you in resolving the problem. Please enter our Agent Code numbers
if you enroll on-line:
SmileSaver: 19893
DeltaCare USA: 2421
I downloaded a brochure and my computer can't
open it.
Brochures are available on-line in the .pdf format which requires Adobe
Acrobat Reader to view the files. If you do not have Acrobat Reader installed
on your computer, you won't be able to view the files. You can download
Acrobat Reader for free from Adobe's Web site. Alternatively, you can
request to have a brochure
sent to you by snail mail or by fax.
What about medical coverage? Do you offer that
type of coverage?
We specialize in dental coverage only. However, you can request medical
quotes from our associates at:
Jordan Shields Insurance
15 Brooke Drive
Novato, CA 94947
(415) 878-0260
How do I find out the monthly or annual cost of
individual/family plans?
Rates and plan availability are based on your location. We represent many
different plans. Not all plans are available in all areas. We need to
know your city and zip code to provide information and rates for those
plans offered in your area. The rates are included in the brochures, which
you can view and download (choose from Indemnity
or DHMO plans), or request
either type of plan via fax
or snail mail.
Can I fax the completed application form to you?
We can only accept the SmileSaver application form if you are paying via
credit card. If you are paying via check or money order you will have
to send us the application and payment. The other carriers require that
we have your original application and signature and do not accept faxed
copies.
Why are the DHMO plans so much less expensive?
Because the DHMO plans generally do not pay claims. They have contracted
with the dentists on their list to provide covered services at lower fees.
The dentist is assuming the risk by charging lower fees for the treatment
they provide. Sometimes the dentist receives a percentage of the monthly
premium cost to help offset the lower fees. The DHMO plan has fairly low
overhead. They have the expenses of maintaining the provider panel, marketing
their plans, issuing ID cards, sending bills and customer service. But
the biggest expenses of a traditional insurance plan are the claims payments,
and DHMO plans do not incur this expense.
What is a PPO plan?
Many people call us asking for a PPO plan, but they really want a plan
that allows them to use the dentist of their choice. PPO stands for Preferred
Provider Organization. A PPO plan has a network of dentists who have agreed
to charge reduced fees (typically 20-40%) to patients of a particular
insurance company. The insurance company benefits with reduced claims
costs and the patient benefits with reduced out of pocket costs. PPO plans
also give you the option of using a non-PPO dentist. However, when you
use an out of network dentist, the insurance covers a smaller percentage
of the treatment and pays a much smaller part of your dental bill. Most
carriers do not offer individual PPO plans. PPO plans are an excellent
and popular option for employers. But if you are an individual or family
and you want to use your own dentist, look at the individual insured/indemnity
options on the Individual Plans
page. Since PPO plans are rarely available to individuals and offer such
low coverage out of network, you are probably better off with an insured
plan.
What is your agent code?
SmileSaver: 19893
DeltaCare USA: 2421
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