Frequently Asked Questions
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Dentists and Networks
Q. I haven't been to the dentist in a long time.
Does that make a difference in my rate or coverage?
A. Absolutely not!
Q. What is guaranteed acceptance?
A. Regardless of your current or past dental history,
your acceptance into this plan is guaranteed as long as you are between the ages
of 18-99 and live in an approved state.
Q. Will my same-sex partner/domestic partner be
eligible for spouse coverage?
A. If the law in your state does not recognize same-sex
marriages, then your partner will not be eligible for spouse coverage.
Q. How many check-ups and cleanings does the plan
A. Both of our primary insurance plans pay for 2 check-ups
and cleanings at the dentist EVERY year! One time every six months.
Q. Does this plan cover tooth extractions?
A. Absolutely! Tooth extractions (oral surgery) are
covered by all plans. Waiting periods for this procedure will vary depending on
the plan you choose. Please check the
Product Benefits page for full details.
Q. Do any of these plans cover braces or orthodontia?
A. Not yet! We are currently developing a product for
child orthodontia. Please check back often for updates.
Q. What is an annual deductible?
A. Each year, you will have an annual deductible which
is the amount you will pay out-of-pocket before benefits are paid. This amount does
not include co-payments.
Q. Do these plans have a "deductible"
A. There is NO deductible for preventative and diagnostic
dental care. For basic or major dental work, you pay the first $50 each year (your
deductible). For family coverage, there is a $150 maximum deductible per family,
Q. What does “usual & customary”
A. The average cost a dentist charges for services in
Q. Will my premium increase?
A. You will never be singled out for a premium increase
due to your claims or usage or age. Premiums are guaranteed to stay the same for the first
twelve months. After that, premiums could increase on an annual basis to all insureds in your Class.
Q. Are there penalties if I cancel the coverage?
A. You have the right to cancel this coverage at any time for any reasons with no penalties.
If you cancel this coverage, we can reject any new dental insurance
application/enrollment form you submit during the one year period following the
date of cancellation. Coverage can stop if 1) the Group Policy stops, 2) coverage
is cancelled for everyone in your class, or 3) the insured performs an act of fraud
or makes a material misrepresentation regarding this coverage. If coverage is to
be discontinued due to reasons 1 or 2, we will notify you 60 days in advance.
Q. What are the waiting periods?
A.The waiting period depends on the plan you choose. With the Encore Dental® 1-2-3 Insurance Plan there are no waiting periods for any type of service including Major! Our Encore Dental® Standard Plan A or Plan B has no waiting period for Preventative and Basic services, and a 12 month waiting period for Major services. Please check the Product Benefits pages for full details.
Q. Do I have to use one of the plan's network dentists
or can I see my own dentist?
A. You can see your own dentist or ANY dentist you like.
You do NOT have to use an in-network dentist. Of course, you may find you will have
less out-of-pocket expenses if you choose to use an in-network dentist because they
all guarantee to charge lower pre-negotiated prices to Encore Dental®
Q. How do I find out if my current dentist is in
the network, or how do I locate an in-network dentist?
A. Click on our
“Find a Dentist” link, or call 1-866-605-2642.
Please remember, you do not have to use an in-network dentist for this plan to provide
coverage. You have the flexibility to use any licensed dentist and still receive
benefits for covered services.
Q. What are advantages of using an in-network dentist?
A. In-network dentists agree to charge fixed, pre-negotiated
prices for their services which can provide you an opportunity to save more. In
addition, when using an in-network dentist you do not have to submit a claim form -
they will handle the claim’s paperwork for you.
Q. How are my claims reimbursed?
A. When going to an in-network dentist, there are no
claim forms. The dentist will submit the bill for you. When going to an out-of-network
provider, you will submit a claim form and then we will send you a check for what
your benefits covered. You can obtain a claim form by selecting the
“Claim Information” link located
at the top of the page or by calling 1-866-605-2642.
Policy/Certificate #: SLDT1000IP/SLDT1000GC/GC537/D491.
This coverage is issued by Stonebridge Life Insurance Company, an AEGON company.
Stonebridge Life Insurance Company NAIC number 65021. Not available in all states.
Administrative Office: 2700 W. Plano Parkway, Plano, TX 75075-8200. Home Office: Rutland VT 05701.
© Copyright 2011, Stonebridge Life Insurance Company.