Frequently Asked Questions

Primecare Dental plan


Q:
How many times a year can I have my teeth cleaned?
Primecare Dental covers routine cleanings at your selected general dental office twice a year.


Q: What is a pre-existing condition? Is it covered?
A pre-existing condition is any dental or oral health condition, which existed before joining the plan. Primecare Dental does not exclude pre-existing conditions on the offered plan.


Q: What is work in progress? Is it covered?
Work in progress is dental work that was started prior to joining the plan. It is the responsibility of the treating dentist to finish all procedures that were begun prior to the end of the client’s contract term.


Q: Are cosmetic procedures covered? If so, what procedures?
Dental treatment which in the opinion of the Plan dentists is for cosmetic purposes, unless necessary for the dental health of the Member consistent with professionally recognized standards of practice.


Q: Is Orthodontia Covered? What are the Orthodontia benefits? If yes, is Invisalign braces covered?
Yes. Primecare Dental Plan provides complete orthodontic coverage.


Q: Do I need to obtain claim forms?
There are NO claim forms to fill out.


Q: Is there a waiting period?
No, you can begin using your Primecare Dental plan once it becomes effective.


Q: Is this insurance?
The plans offered are dental HMO benefit plans.


Q: Can I change my dentist once I am in the plan?
Yes. You have control over the choice of selected general dental office, and you can make changes at any time before the 25th of each month. If you need or desire to change your selected general dental office, please contact Primecare Dental's Member Services. In most cases your transfer will become effective on the first of the month following your request.


Q: My dentist isn't currently in the directory. What can I do?
Call member services and give us your dentist's information. We will contact him/her about becoming a Provider.


Q: How long does it take to process my application?
Application processing times may vary based upon type of payment received.


Q: When will I receive my enrollment package and what will it include?
The enrollment package will be emailed a few days prior to your effective date, usually the 27th or 28th of the month. The subject of the email will be "Welcome to PrimeCare Dental Plan!" and it will include your Certificate of Coverage and ID Cards.

If a valid email address is not given, a representative from Primecare will contact the member for a valid email address.


Q: If I choose to pay by credit card, what will my credit card statement read?
When paying by credit card, your statement will read “Primecare Dental”.


Q: If I choose to pay by Bank Account Draft (ACH), what will my bank statement read?
When paying by Bank Account Draft, your statement will read “Primecare Dental”.


Q: Is the processing fee billed separately or with the premium?
For your convenience, your one time processing fee is billed with your premium.


Q: Can I change my payment type once I am in the plan?
Yes, you may change your payment type at any time by calling Primecare Dental’s Individual Billing Department.


Q: If I started with monthly payment, can I change it to annual payment at a later date?
Yes, you may change your payment type at any time by calling Primecare Dental’s Individual Billing Department.


Q: What if I need to change my membership from Individual to Family Coverage?
Please contact Primecare Dental’s Member Services Department to add any family members to the plan.


Q: Do the applicant name and the billing name need to be the same?
No, the applicant name and the billing name do not need to be the same.


Q: How do I add or cancel coverage for a dependent?
Please contact Primecare Dental Member Services and they will assist you in adding or canceling your membership for additional members.


Q: If I cancel the policy, will I receive a refund of the premium or processing fee?
Your enrollment is for a continuous period of 12months. You may, however, cancel your policy within the first thirty (30) days after enrollment and receive a full refund, PROVIDED, that you have not used your benefits during that period.