Where am I allowed to go for dental treatment?
Member must use in network providers. You can access and customize your provider search online at lifesmileplan.com or goldendentalplans.com. You may also call 800-451-5918 and a GDP representative will be happy to help you locate a provider in your area.
What are the benefits provided under my current dental plan?
Your Dental benefits will vary based on the plan you are enrolled in. When your enrollment is completed you will receive a summary of your benefits within your welcome packet. If you need further assistance with your benefits you may contact GDP and a representative will be happy to assist you.
How will I know if I have out of pocket expenses?
Your primary dental provider should be able to provide you with a treatment estimate explaining any out of pocket cost you may have. You may also contact GDP to inquire about co-pay percentages.
How do I know if I have reached my maximum benefit?
Your dental provider will have a record of the benefits paid on your behalf, or the amounts they are expecting to receive from your carrier. They will also have a record of when your plan renews.
How do I know if my treatment is covered?
Your dental facility should have an understanding of the procedures that are covered, and this should be reflected in your treatment plan. You may also request your dental facility to submit a prior authorization to your dental carrier which will give a more accurate estimate of your proposed treatment. You may also contact GDP representative for further assistance.
Am I able to change providers once I am assigned to a specific office?
You may change facilities at the 1st of any month. If you go to a facility and find that you would like to change to a different provider, for any reason, you may simply contact Golden Dental Plans and a GDP Representative will change you to the contracted provider of your choice effective the 1st of the next month. All family members must be assigned to the same provider.
When will my benefits take effect after enrolling?
If a member is enrolling in our plan through their employer, the employer will determine the effective date of the contract. Information sent to us to enroll an employee via fax, e-mail or electronic download is entered into our system within 24 hours.
If a member is enrolling through a self-pay program, monies received before the 25th of a month, will be applied for eligibility the 1st of the next month. Example: Member sends in premium payment on 16th of the month – effective date will then be the 1st of the next month.
How will I know if a new provider joins the GDP Network?
GDP will send an introduction letter to members that a new provider has signed up in their area via mail or e mail. Members may also utilize the dentist search on lifesmileplan.com or goldendentalplans.com which updates as soon as new providers are added to the network.
What should I do if I have a dental emergency and I am unable to access my primary dental provider?
Golden Dental Plans Providers are contracted to see our members within 24 hours for emergency treatment. However, should your provider be unavailable, members may contact our office for further instructions on transferring into another facility for emergency treatment. Golden Dental Plans also contracts with some walk-in facilities.
If a member is beyond a 50-mile radius of their contacted provider there is an allowance for (up to) $100.00 reimbursement for emergency treatment of pain (palliative treatment) until the member can get back to his/her network provider.
Can I take my child to a pediatric dental provider?
Members can take their children to any pediatric dental provider without a referral up to the age of 7. Once the child turns 7 they must have a referral from the assigned primary dental facility. Out of pocket cost may be higher. Contact a GDP representative for full details.
What kind of coverage do I have for Braces?
Golden Dental Plans covers a standard 2-year full banding treatment of adult dentition (adult teeth), once in a lifetime which is considered Comprehensive Treatment;
All orthodontic treatment must be through a Golden Dental Plans contracted facility. Referral from the primary care dental office is not necessary. Pre-orthodontics, otherwise known as Interceptive Treatment is not a covered benefit. The benefit amount will depend on the plan you are enrolled in. Contact a GDP representative for full details.
