Commonly Asked Questions


Question: Do I have a yearly spending Cap-Off amount?
Answer: No...There is no annual dollar limit and you may see your dentist as often as needed to complete your dental work.


Question: Are pre-existing conditions covered?
Answer: Yes


Question: Is there a waiting period before I can see the dentist?
Answer: No...You can begin using your dental plan for both basic and major services the first of the following month when your dental plan goes into effect.


Question: Are there any deductibles?
Answer: No...You pay set co-pay amounts for your primary dentist services which will vary depending on your procedures.


Question: Is there a Contract?
Answer: Yes...There is a 6 month agreement giving you enough time to get your dental services completed. This will also allow adequate time for the dental office to submit you're claims, thereby ensuring coverage.


Question: Can my child over the age of 21 be on my policy?
Answer: Yes...Children may continue on your policy until they reach the age of 25 in Texas and California and until age 26 in Florida.  At that point, they are required to have their own policy, unless they are mentally or physically disabled. In that case, you must submit proper documentation showing such circumstances and he or she will remain a dependent.


Question: Is there a limit to the number of dependents I am able to put on my policy?
Answer: No... You may put as many dependents on your plan as needed as long as they qualify as a dependent.


Question: Do I have to be married to add my spouse?
Answer: No...It can be a boyfriend/girlfriend situation or even a same sex situation as long as you both reside together.


Question: Do I have to stay with one dentist or can I change?
Answer: You may change your primary dentist every month if you choose to do so, giving you the opportunity to find a provider that you are comfortable seeing.


Question: Can I see any dentist I want?
Answer: No...You must see one of our in network providers who are contracted to honor the set co-pay prices. This will protect you as a consumer from being over charged.


Question: Are specialists covered?
Answer: Yes...You may see a specialist under this plan at a 25% discount.  However you must be referred to one by your primary dentist before setting an appointment.


Question: Can this Plan be used with other Dental Plans?
Answer: Yes, as long as you are using the NA245D dental plan as your Primary Plan in conjunction with an Indemnity Plan (PPO dental plan).  You may submit your paid receipts to your secondary Indemnity Plan for reimbursement.


Question: Do I need to be issued a Benefit Card before seeing a Dentist?
Answer: No...It takes 2-4 business weeks to receive your Benefit Cards from the time of enrollment, but you may see your selected primary dentist if an appointment is scheduled after the 7th of the effective month of your policy.


Question: How do I find a primary Dentist in my area?
Answer: You can visit our website at www.dental5copay.com and click on (Find a Dentist) this will guide you through the proper steps for finding an NA245D dentist in your area.


Question: What are my Vision and/or Rx Benefits, and are they included when I enroll?
Answer: Yes...Both Vision & Rx Savings Cards are provided to you through this Plan at No additional charge. You will receive a vision discount card from Coast To Coast Vision TM, which is administered by New Benefits; this is not insurance. The discount Rx card is from Free National Rx Card. You will receive up to 75% off generic and up to 15% name brand drugs as well as discounts on Lab Work, MRI, Cat Scans and Pet Medications.


Question: Can I add Dependents at a later time?
Answer: Yes...You may add dependents at any time to your dental plan without any additional enrollment fees, but your premium will increase to reflect the additional person/people added “on your selected draft date” for the following month.


Question: What will happen after my 6 month enrollment period?
Answer: After your 6 month initial period has passed, your policy will remains in effect. It will not automatically cancel.  Your savings on just your maintenance alone (cleanings, x-rays, etc...) will cover your premium cost each year.


Question: How am I billed for these benefits?
Answer: The association only accepts EFT payments set up through your bank (checking or savings) or credit card on a recurring basis.


Question: What is the difference between a dental discount plan and a dental HMO plan?
Answer: Dental discount plans vary greatly in “supposed” savings. Dental HMOs have a predetermined co-pay for every procedure.  The 340 covered procedures at copay prices are listed in the dental benefit book you will received after you enroll.  Dental HMOs provide “Big Savings”. (Ex. Crown: Usual Fees $900 - $1000. HMO co-pay $245 co-pay plus a $150 lab fee, total cost $395. That's “Big Savings”!)