General Dental Questions
No. You may enroll in a FCPS dental plan regardless of whether you enroll in a FCPS medical plan.
Your dental plan covers:
- Preventive & Diagnostic services, such as routine dental exams and cleanings, and x-rays.
- Basic Restorative services, such as fillings.
- Major Restorative services, such as root canals.
- Orthodontia, services to correct misalignment of teeth.
FCPS offers a Dental PPO (DPPO) plan and a Dental HMO/DNO (DMO/DNO) plan. Here’s how they differ:
With the DMO/DNO plan, you must select a primary care dentist (PCD) when you enroll. Your PCD provides certain types of dental care (such as routine preventive care and basic services) and can refer you to specialty dentists for other types of care. The plan pays benefits only when your PCD provides or refers your care. There is no deductible to meet, and you pay a flat fee (called a copayment or copay) for most covered services. Preventive and diagnostic services are covered in full, with no copay required. There are no benefit maximums.
With the DPPO plan, you are not required to select a PCD. Preventive and Diagnostic services are covered in full when you use an in-network dentist. If you use an out-of-network provider for Preventive/Diagnostic, Basic and Major services, you must meet a deductible each year before benefits begin. Once you’ve met the deductible, the plan pays part of your covered expenses and you pay part (coinsurance). The DPPO plan has an annual maximum benefit that applies to Basic and Major services.
Orthodontia coverage: The DMO/DNO plan provides coverage for dependent children and adults. There is no deductible or annual and lifetime maximum amounts.
The DPPO plan only covers dependent children under the age of 20. Additional features of the DPPO plan include a deductible for Orthodontic services provided by out-of-network dentists and annual and lifetime maximum amounts.
You can visit the Dental Plan Info page to see a summary of your dental benefits, including deductible, coinsurance and copayment amounts for the four types of dental services.
With the DMO*/DNO plan, you access care through the primary care dentists (PCD) you select. Each covered family member may select a different PCD. Your PCD provides basic and routine dental services and supplies and will refer you to other dental providers in the network.
- To find a network dentist in your area, use the provider search tool or call Member Services at 1-877-238-6200.
- Then, call Member Services at 1-877-238-6200 between 8:00 am and 6:00 pm EST, Monday-Friday to designate the dentist.
Your PCD will be effective on the date that you make the initial election. If you are changing your PCD, you must call by the 15th of the month for the change to be effective the 1st of the following month.
*In Virginia, the DMO Plan is known as the DNO Plan. DNO (Dental Network Only) in Virginia is not an HMO. To receive maximum benefits, members must choose a participating primary care dentist to coordinate their care with in-network providers.
If you have questions about your dental benefits or how your plan works, call Member Services toll-free at 1-877-238-6200.
You can receive an extra cleaning or visit to a dentist to treat gum disease if you are pregnant or have diabetes or heart disease.
If you enrolled in or changed plans during open enrollment, you can expect to receive new member ID cards in late December for coverage effective January 1, 2023. For other events, you will receive new member ID cards within two weeks of your enrollment. If you do not receive your new ID card, please call Member Services at 1-877-238-6200.
You will receive a family ID card. All covered members of your family may use the same card. If your spouse is covered by the plan, you will receive two ID cards. If you need additional ID cards, please contact Member Services at 1-877-238-6200.
You have two ways to do this:
Online - Log in to your member website. Click ID Card on the top section of the home page.
By phone - Call the toll-free Member Services number on your member ID card 24 hours a day, 7 days a week. The automated telephone assistant recognizes natural speech, or you can make your selections from your touch-tone keypad. Say, “Order an ID card” and the system will guide you from there. You can also speak live with a Member Services representative during regular business hours.