Yes. At the time of enrollment, you will select two participating dentists. This will help ensure you are able to receive the care you need if your first choice is unable to accept new members. The participating dentist you select at enrollment will provide your routine dental care. You may schedule an appointment with your dentist any time after your plan’s effective date. Please note: Except for Emergency Dental Services, out-of-network benefits are not available through this DHMO plan.
This plan’s network includes both private practice dentists and those who are in a clinic environment. Every dentist in the network has been thoroughly screened prior to acceptance. Participating dentists are also subject to regular audits, including onsite visits to the dental offices. You can find the names, addresses, languages spoken and telephone numbers of participating dentists by searching our online Find a Dentist directory for the most up-to-date information.
Yes. You and your enrolled dependents may each select different participating dentists and may change dentists as often as once per month. You can change dentists for you and your enrolled dependents online or by calling Customer Service. Your transfer will be effective the first of the following month. Please note: you should ensure any dental work-in-progress is completed prior to transferring to a new dentist. Refer to your Evidence of Coverage included in the “Your Benefits” section of this site and with your enrollment materials for more information.
All participating dental offices in our network provide emergency access 24 hours a day, 7 days a week. If you cannot reach your selected participating dentist, you may receive emergency care from any licensed dental care professional. The definition of what is considered “emergency care” and other specifics can be found in the Evidence of Coverage included in the “Your Benefits” section of this site and with your enrollment materials.
While these facilities cannot accept new patients, you may not have to change dentists if you are currently a patient in one of those offices. It is important that you contact Customer Service in order to ensure that you can continue using your current facility under the plan.
This is a "direct referral" plan which means your selected participating dentist will refer you to a participating specialist in your area – there is no need to wait for approval.* Any copayment amounts for services listed on your Schedule of Benefits. This copayment applies whether the services are provided by your selected participating general dentist or by a participating specialist.
Yes. Just contact Customer Service to let us know that you would like another clinical opinion and we will provide the name of a dentist for you to see.
No. We will provide you with an ID card when you enroll, but it is not necessary to receive services. The card is not a guarantee of coverage or eligibility, but does highlight toll free numbers and the web address that can be used to access benefit information about your dental plan.
Your selected general dentist receives a list every month of all DHMO members enrolled in his or her practice and may also verify eligibility with us prior to your appointment.
If you would like a card, there is also a temporary ID card in the front of your enrollment kit, or you can print one from our interactive website.
No. You and your dependents may select different dentists. Just make sure you include the facility numbers on the Provider Selection Form for the facilities each family member has chosen. If your form is submitted without facility numbers, there could be a delay in being able to access care.
Your Nexus 150 plan includes many of the most popular cosmetic procedures available today. Bleaching, veneers, white fillings, and adult & child orthodontics (braces) are all included at copayments that may be considerably lower than you would pay without this dental benefit plan.1
Please refer to your Schedule of Benefits for complete information.