Q. Who is Flagship?
A. Flagship is a subsidiary of Delta Dental Plan of New Jersey and administers the DeltaCare program. DeltaCare is a dental HMO which offers dental care to its members through a network of private practice dental offices.
Q. My dentist is a Delta dentist, but he or she is not on the list. Can I still have treatment rendered by him or her?
A. No. Delta has several other dental programs and not all Delta dentists participate with all Delta programs. With this program, you MUST select only those dentists on the list. If you use a dentist who is not on the list, you will NOT be covered.
Q. Will my entire family receive dental care from the same DeltaCare provider?
A. YES. You and all eligible dependents will receive benefits in the same provider’s office.
Q. How long does it take to get an appointment with a dentist?
A. Three or four weeks is a reasonable amount of time to wait for a standard appointment. If you require a specific time, you may have to wait longer for an appointment.
Q. If I have a pre-existing dental condition, may I join DeltaCare?
A. YES. Pre-existing conditions are not excluded under the DeltaCare program. However, benefits will not be provided for any dental treatment which began prior to becoming eligible under the DeltaCare program. (Work in progress, i.e. preparation for crowns, root canals, impressions for dentures, etc.)
Q. Does DeltaCare program provide coverage for specialty services?
A. YES. Flagship maintains a panel of specialists and coordinates all your specialty care needs with your primary care dentist. If specialty care is required, your primary care provider will request authorization from DeltaCare to refer you to the appropriate specialist. Certain specialty care must be pre-authorized by Flagship.
Q. Once I have selected a dental provider, may I change my primary care dentist?
A. YES. You may change your eligibility from one primary care dentist to another by phoning or writing Flagship by the 16th of the month. The change will be effective on the first day of the following month. However, requests to change dental providers should not be made if a patient is in the middle of treatment. A Flagship Customer Service Representative can advise you on the definition of “middle of treatment.”
Q. Whom do I contact if I need assistance?
A. Flagship Customer Service can assist you in all matters pertaining to the DeltaCare program. You may reach a Flagship representative at one of the numbers listed on the back of this brochure. Office hours are 8:00 a.m. to 4:30 p.m., Monday through Friday.