Alpha Dental Plan
A. Membership and Application
It’s easy! To join, simply fill out the application. Everyone is eligible and qualified to sign up for this plan. There are no dependent eligibility guidelines.
B. Your Effective Date
Depending on your payment choice, coverage for you and your enrolled dependents will begin as follows:
- If you choose to pay by CREDIT CARD, your account will be debited the full annual amount. The monthly cut off date is the 25th. If we receive your application and credit card information by that date, you will be able to use your benefits on the first day of the next month. If the information is submitted after the 25th, your benefits will be available the following month.
- The monthly cut off date is the 14th for Bank Draft Option. If you choose the BANK DRAFT option, the first debit will be on or about the 14th of the month and you will be able to use your benefits on the first day of the month following the first debit.
- If you would like to pay by DIRECT BILL, you will be billed quarterly or annually and will become active once the initial bill and payment are received in the office. Members will be put in the system but on hold status until payment is processed. If your payment is received by the 20th of the month you can use your benefits on the first day of the month after your payment is processed.
C. How does the Plan Work?
What we do as a carrier is pre-negotiate discounted fees with dentists in your community and pass these savings on to you. We also offer the contracted dentists a guaranteed income every month as they are receiving a portion of the month premium you are paying us regardless of if you (or a family member) visit their office that month or not. When you see your plan dentist, the negotiated fee is considered payment in full!
D. Choice of Provider?
You must seek services by a participating Beta Health provider to receive the discounted fee. We have the largest number of participating providers in Colorado with over 600 dentist contracted statewide. The network link is available below; this will enable you to reference a specific city in Colorado to see if we have a contracted provider in your area. Please note that approximately 78% of the dentists in each location below are General Dentists and the other 22% are Orthodontists. The other contracted dental specialists are not included in this list.
E. Specialty Care/Specialist Referrals
Plan specialists offer discounts ranging from 10% to 20% off their normal fee. Plan specialists are statistically only need approximately 5% of the time.
F. Emergency Dental Services
Dental emergencies are handled by contacting the Beta Health Administrative Office.
G. Coordination of Services
There are typically no coordination of services between other plans and the Beta Health discount plan.
H. Cancellation Policy
You must be enrolled initially for a minimum of one year (unless you move out of the service area). A 30 day written notice of cancellation is required after this one year requirement.
I. Plan Exclusions/Limitations
Limitations and Exclusions:
- All fees listed above do not include all appropriate lab fees. Member must agree (in writing) to all upgraded materials
before treatment is started. See each section for specific details (if applicable).
- All patients are responsible for paying all fees (as listed above) at the time services are rendered.
- These fees are for General Dentists only. A participating specialist list is available by calling our office at 303-744-3007 or 1-800-807-0706.
- Any procedures not listed will be discounted 20% off the participating General Dentists normal fees.
- Medical costs associated with any dental procedures are not covered.
- Dentures or appliances will be replaced only after 3 years have elapsed since such dentures or appliances were provided under any plan program, unless the denture or appliance becomes unserviceable due to illness or other causes not controlled by other means. Replacement of dentures, appliances, or bridgework due to loss or theft are not covered.
- Any dental treatment started prior to the Member's eligibility to receive services under this plan or started after a Member's termination are not covered.
- Failure to follow the prescribed treatment or accidents occurring during the course of treatment may result in additional charges by your plan provider.
- Failure to pay scheduled fees at the time service is rendered may prevent future dental services from being received until all fees have been paid in full.
- Services provided by non-participating dentists are not covered.
- Services which, in the opinion of the attending dentist, are not necessary for the patient's dental health, or are contrary to established dental ethics are not covered.
- Cosmetic dental procedures are covered only if the attending dentist and patient agree on the specific procedure.
- Services which are compensable under Worker's Compensation or employer liability laws are not covered.
- General anesthesia and IV sedation are not covered.
- Myofunctional therapy procedure for training, treating or developing muscles in and around the jaw or mouth including TMJ are not covered except by participating plan specialists.
- Any dental procedure or service that cannot be performed in the dental office due to general and/or physical limitations of a member are not covered.
- Expenses incurred for dental procedures initiated prior to member's eligibility or after termination are not covered.
- Any services that the Participating General Dentist recommends be performed by a specialist are covered only by a plan participating specialist.
- The liability of Beta Health Association, Inc. is limited to the return of the membership fee's paid for one year by the member.
- Extractions for asymptomatic third molars (wisdom teeth) are not covered unless causing movement of the teeth. An example of symptomatic include severe decay, and ontogenic cysts, chronic pericoronitis, and infection.
- The Beta Health Association, Inc. dental programs do not constitute dental insurance and are considered discount, fee-for-service dental plans.
- Fee's are subject to change on an as needed basis. Please contact Beta Health Association, Inc. for current fee's.
Other Orthodontic Guidelines
- A $350 charge will apply at the end of treatment (included in the above amounts) to cover all retention office visits (unlimited).
- Services not listed above will be discounted 30% off of the participating Orthodontist's Usual and Customary fees (except #5 listed below).
- Services must only be provided by a contracted Orthodontic Specialist.
- The amounts listed above also include an initial one-time $225 charge for all records, mold, x-rays, etc. to determine the Orthodontic Treatment for the patient.
- Invisalign® procedures are to be discounted 15% off the participating Orthodontist's Usual and Customary fees.
J. Grievance Procedures
All Grievances are handled by contacting the Beta Health Administrative Office.