Below are answers to commonly asked member questions. Please keep in mind that your Evidence of Coverage (EOC) or Certificate of Insurance defines the specific benefits of your plan.

DENTAL FAQs
DHMO
Q5: How do I receive benefits under my dental plan?
Q6: How do I change my dental provider?
Q7: My dentist wants me to see a specialist. Am I covered?
Q8: Does my plan automatically entitle me to a free cleaning? (DHMO plans only)
Q9: How long do I have to wait to get an appointment with my dentist?
Q10: What is the procedure for emergency visits?

DENTAL FAQs: DHMO

Q5: How do I receive benefits under my dental plan?
Members of Health Net Dental HMO plans must choose a selected General Dentist from our contracted network of providers. To choose a dentist based on your location, please use our DocSearch page. Within 7-10 business days, you will receive your member ID card, which lists your name and dependent coverage status. When making an appointment with your assigned provider, remember to identify yourself as a Health Net member.

Q6: How do I change my dental provider?
Contact Member Services (see Contacts page) before the 25th of the month and your change will be effective on the 1st day of the following month. Once your change has been completed, you will be issued a new identification card.

Q7: My dentist wants me to see a specialist. Am I covered?
DHMO members whose plans include coverage for specialty services may be eligible for such treatment. Check your Evidence of Coverage booklet or contact Member Services (see Contacts page) for plan specifics. Referrals to specialists must have prior approval.

Q8: Does my plan automatically entitle me to a free cleaning? (DHMO plans only)
When you receive your initial dental exam, your dentist will let you know what kind of cleaning you need. Simple cleanings are often provided at little or no cost to you. However, if you have not been to the dentist in some time, you may require a deep cleaning, or other procedure that might require an additional expense.

Q9: How long do I have to wait to get an appointment with my dentist?
This depends upon appointment availability at your assigned dental office. In most situations you should be able to schedule a routine dental appointment (unless you are requesting a specific time or day of the week) within three to four weeks. Emergency visits should be scheduled within 24 hours.

Q10: What is the procedure for emergency visits?
In the event you require emergency dental care, contact your Selected General Dentist Office to schedule an immediate appointment. If your dentist isn't available, you must contact Member Services for assistance. If you are more than twenty-five miles from your chosen Selected General Dentist Office, or you cannot reach your dentist or Member Services, you may obtain emergency dental services from any licensed dentist. To be reimbursed for a dental emergency, you must notify Member Services within forty-eight hours after receiving dental emergency care services. Member Services will request a copy of the bill incurred along with a brief explanation as to the unavailability of your dentist. No claim forms are required. After verifying the circumstances, we will reimburse you for the expenses for covered services, up to a maximum of fifty dollars ($50.00) per occurrence, less any applicable co-payment.

Please refer to your Evidence of Coverage (EOC) booklet for full plan details.

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