A: For applications received on or before the 20th of the month, coverage will begin on the first day of the next month. For applications received after the 20th of the month, the coverage will begin the following month. If the application is received on January 19th, coverage will begin in February. If the application is received on the 21st, then coverage begins in March.

A: All residents and their dependents are eligible for coverage, unless you cancelled your policy with in the last 12 months, at which time, you will have to wait 12 months from the cancellation time to reapply. Spouses and unmarried children under 19 years of age, or 26 years of age if a full-time student, count as dependents. Children may also have their own policy if residents of North Carolina.

A: If you cancel your coverage, you must wait 12 months before purchasing the policy again.

A: Your policy renewal is January 1 of each year, and any rate changes will occur at that time.

A: All licensed dentists in North Carolina are eligible for visitation. Members have the freedom to visit whomever they would prefer.

Simply present your insurance ID card to the dentist of your choice and receive your benefits. Dentists may check the eligibility of members by contacting Customer Service or the 24 hour automated system.

A: Waiting periods do not exist for preventive and diagnostic services. The waiting period dictates individuals must wait six months for basic services and wait twelve months for major services before receiving services covered by dental insurance. The waiting period begins once the policy becomes effective. The accompanying benefit booklet provides a complete listing of services.

A: Your $75 deductible is applicable to basic and major dental services. Once you pay the deductible, the provider will cover 50% of the allowable charge, up to the allowed annual maximum of $1,000. The above description applies to each member covered under your policy.

A: After the visit, pay the dentist in full and submit a claim for reimbursement, unless the dentist accepts assignment of benefits. Please be certain to mail your claim within 180 days of your visit.

A: Representatives can assist you 8:30 a.m. to 8:00 p.m. Monday through Thursday and 9:00 a.m. to 8:00 p.m. on Friday, with any questions concerning claims payment, explanation of benefits (EOB’s), pre-treatment estimates and additional benefit coverage questions.

A: No. Orthodontic care is not covered.

A: The allowable charge is based on 85% of the HIAA (Health Insurance Association of America) index. Thereby, 85% of dentists in a specific zip code area charge equal to or less than our allowable charge.