ShelterPoint Life Insurance – Formerly First Rehab Life 1972 Located at
1225 Franklin Avenue, Ste. 475, Garden City, NY.
Phone: 516-82908100

Dental

1. How do ShelterPoint and DenteMax work together?

ShelterPoint Life is your insurance carrier, providing you with a quality Dental Care plan. DenteMax is a network enhancement to your underlying dental coverage from ShelterPoint: participating dentists have accepted a fixed, lower rate schedule of fees when receiving payment for their services. DenteMax links dentists, patients, and providers together. Your Benefit Plan Administrator can explain your specific benefit levels and fees

2. How can I find a participating dentist?

Simply follow this link to the DenteMax website and search for a location that’s convenient for you.

3. How much can I save if I choose a DenteMax dentist over a provider who is not in the network?

DenteMax dentists have agreed to accept fees with an average 25-40% below usual charges. So your out-of-pocket expenses may be reduced.

Here’s an example:

Non-Network Dentist   DenteMax Dentist  
Dentist’s fee $850 Dentist’s negotiated DenteMax fee $600
Allowable charge $800
Co-insurance 50% of allowable charge Co-insurance 50% of negotiated fee
Policy pays $400 Policy pays $300
You pay $450 You pay $300

In this example, you save $150 using a network dentist!

This is an example. Dollar amounts in this chart are for illustration only. Actual charges may differ from this example.

4. What do the numbers for in-network co-insurance mean?

These numbers indicate how much of the network dentist’s negotiated DenteMax fee for a specific procedure is covered by the policy. Let’s assume, for example, you choose a 100-80-50 plan: The first number always shows the coverage percentage for preventive services – in this case 100%. This means that preventive services are fully covered and that you don’t incur any out-of-pocket expenses. The second number indicates the coverage percentage for basic services, and the third number refers to major services. So, if the co-insurance is set at 80%, for example, your policy covers 80% of the participating dentist’s negotiated DenteMax fee for the particular procedure. And you pay the balance between the covered amount and your dentist’s bill.

5. How does the co-insurance work for out-of-network providers?

Out-of-network co-insurance works similarly to in-network co-insurance. However, if you receive services from a non-network dentist, the co-insurance numbers indicate the covered percentage of the maximum allowable charge for a specific procedure in your area – not the negotiated fee of a network dentist. Let assume that dentists usually charge $800 for a particular major procedure in your area and that your dentist bills you $850: The co-insurance under this policy pays based on the maximum allowable charge – $800 in this case. So, if your co-insurance is set at 50% for a major procedure, the policy would pay $400. And you would pay the balance between the covered amount and your dentist bill, which is $450 in this example.

6. How do I submit a claim?

7. How can I check the status of my claim?

To check the status please visit www.readysetdental.com

8. Who can I contact with a question about my claim?


ContactFor    
Claims questions Dental Claims 800-365-4999  

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Specific claims questions Kate Davenport 800-365-4999 x7770

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