Page 3 Provider network You can choose from one of the 132,000 credentialed providers at any of the 600,000 access points nationwide in the Equitable Dental Network. You can locate an in-network provider by visiting: . Using a www.equitable.com/finddentist network dentist will significantly lower your out-of-pocket expense because these dental professionals have agreed to provide covered services at discounted fees. Equitable does not contract directly with dentists. Equitable’s dental network is supported by several partner companies which may vary by state. This information is provided on our website at . www.equitable.com/dentalprovider Please reference the following network names when confirming in-network participation with your provider. • Careington • Dental Benefit Providers (DBP) • Dentemax Plus • HealthSmart • PPO USA Connection Dental Network (GEHA) • Total Dental Administrators (TDA) • Zelis Dental Network • United Concordia AdvantagePlus Out-of-network dentists have the right to balance bill members for the difference between the provider charge and our maximum allowable charge. Out-of-network dentists are not obligated by contractual agreement to submit claims on behalf of members. Claim forms may be requested by contacting the telephone number or email address indicated on your ID card or above. Provider Availability Please contact your dentist for immediate attention in the event of an emergency. An emergency exists if services are necessary to treat a condition or illness that, without immediate attention, would seriously jeopardize the life or health of the member or the member’s ability to regain maximum function, or cause the member to be in danger to self or others. You may also call our customer service department during business hours for help in locating a network dentist. This applies to all covered services. Standards (Member Access): Dentists • Members must have access to 1 within 30 minutes / 30 miles of their home zip code • • • • • • • • •
Equitable Dental Insurance Benefit Summary Page 2 Page 4