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Anchorage, AK 99503

 
 Home  Health & Welfare  Dental  

Dental - Frequently Asked Questions
 

 

How many times do I have to fill out one of those medical update forms?

The Plan requires that an Annual Medical/Dental Update Form be updated once every twelve months or whenever the patientís information changes.  For example, the form should be updated when a spouseís medical insurance changes through his or her employer.  If you cannot remember when each family memberís form expires, and you anticipate using the Plan within the year, you may download the form in January and fill one out for each covered family member.

An updated Annual Medical/Dental Update Form for the patient must be on file at the Administrative Office for any claims to be processed.  If the Annual Medical/Dental Update Form is not current, the participant will be requested to fill one out and the claim will be not be paid until the form is completed.  The most common cause for a delay in processing a claim is that the patient does not have a current Annual Medical/Dental Update Form on file.

 

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How long do I have to file a claim?

The Plan accepts claims for medical services for twelve months from the date of service.

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Is there a Preferred Provider (PPO) for dental services?

The Plan has no preferred providers for dental services, nor does it maintain a referral list of dentists. You may go to the dentist of your choice. 

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Is fluoride treatment a covered expense for adults?

Yes, all participants and dependents are allowed one fluoride treatment per year.

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My routine cleanings and exams were only  5 months apart - will the Plan still pay for them? Do they have to be six months apart?

Participants and dependents are allowed two cleanings and exams within a calendar year, they do not need to be six months apart.

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Will the Plan pay for a cosmetic treatment I need for my teeth?

No, the Plan will not pay for treatments or services which are primarily for cosmetic purposes.

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Are fluoride toothpaste or other home health care products I need covered under the plan?

Flouride toothpaste and other health care products designed for use at your home are not covered expenses under Plan.

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What dental treatments or procedures do I need to have pre-authorized?

No, pre-authorization is not required for any dental services.  However, intravenous sedation is covered only when treatment warrants the sedation.  If you are unsure whether your treatment warrants sedation, you or dentist may call for pre-authorization.

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I need to travel to another town to have some dental work done.  Will the Plan pay for my travel expenses?

No, the Plan does not cover travel expenses for dental services.

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What does it mean my charges exceeded the " usual and customary"?

Usual and customary charges are the average charges for designated services provided in a particular area.  This information is gathered continuously by a national service.  The Administrative Office receives an update every six months.  Should your provider charge in excess of the usual and customary, you are responsible for all of the amount over the usual and customary.

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Is nitrous oxide covered under the Plan?

Nitrous oxide is a covered expense only for dependent children age 12 and under.  It is not covered for those over the age of 12.

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What types of sedation are covered under the dental plans?

Nitrous oxide is covered for dependent children age 12 and under.  Intravenous sedation is covered only if treatment warrants that type of sedation.  As a rule, general anesthesia is not a covered expense.  Contact the Administrative Office if you have questions regarding sedation and anesthesia coverage. 

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