Dental Plan FAQs
Q. What are the differences between the DMO and the Alternate Dental Plans?
A. Members of the DMO (Dental Maintenance Organization) Plan must select a primary care dentist at the time of enrollment, and that one dentist must direct all your dental care. The DMO Plan pays greater benefits than the Alternate Plan. However, the Alternate Plan allows you to go to any dentist
or specialist you choose, at any time. The Alternate Plan also has a Preferred Provider (PPO) network that can increase your benefits.
Q. How do I find out if my dentist is in the DMO or Alternate PPO plan?
A. You can search through SAMBA´s Provider LookUp Online. Choose either the DMO or the Alternate Plan and from there, you can search by your dentist´s name or location.
Q. How do I choose a dentist if I don´t already have one?
A. You can search for dentists in your area on our website. Go to Provider LookUp and follow the instructions to get a listing of eligible dentists. If you choose a DMO dentist, you must list that dentist´s name and ID number on the enrollment form. If you choose the Alternate Dental plan, you do not have to choose a specific dentist, and you do not need to notify us of who you select.
Q. Are dental implants covered?
A. Dental implant services are not covered under either dental plan option.
Q. My child needs braces. Does the plan cover orthodontia?
A. Yes. The DMO Plan option covers 50% of eligible charges, with no lifetime maximum. The Alternate Dental Plan also covers 50% of eligible charges, up to a lifetime maximum of $1,500. Contact SAMBA for complete details.
Q. When can I enroll in the Dental and Vision Care Plan?
A. You can enroll any time of the year.
Q. How long does the enrollment process take?
A. Generally, it takes four to six weeks, between the time when your application is processed and the date your coverage becomes effective. If you are signing up for the DMO Plan, allow six weeks.
Q. How will I know when my coverage is effective?
A. Once we process your application, you will receive a letter from SAMBA with your effective date. Aetna, the insurance company who administers the dental plan, will send you an ID card.
Q. I am retired from the federal government. Am I eligible for the Dental and Vision Care Plan?
A. Yes. You are eligible and can enroll at any time.
Q. How do I pay my premiums?
A. Depending on where you work, you can pay by payroll allotment, by Direct Debit from your bank account, or by quarterly bill. Retired members can opt for Direct Debit or quarterly bill.
Q. Can I switch from one dental plan to another? What do I need to do?
A. Yes, you can switch from the DMO Plan to the Alternate, or vice versa. If you decide to do that, submit your request in writing to SAMBA: by mail to SAMBA at 11301 Old Georgetown Rd, Rockville, MD. 20852; by fax to 301-816-0191; or by sending an email to feedback@sambaplans.com. We will process your request to change dental plans and notify you when the change will be effective.
Q. How do I cancel my dental plan coverage?
A. You may voluntarily terminate enrollment at any time. Active members who pay by payroll allotment must submit an Allotment Form 299 to cancel the Dental and Vision Care Plan coverage. All other members must submit a written request to cancel coverage. Mail the request to SAMBA at 11301 Old Georgetown Rd, Rockville, MD 20852 or fax it to 301-816-0191. We will notify you in writing of the termination date of the coverage. Keep in mind that once you cancel your dental plan coverage, you cannot re-enroll for two years.
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