Seeing a Dentist

Knowing the difference between network and non-network dentists can save you money

With your dental plan, you can visit any licensed dentist and still have coverage. But, you usually will save money if you visit a network dentist.

 

Why do I save money if I visit a network dentist?

Dentists who participate in your network have agreed to accept negotiated fees (or maximum allowable charges) as payments in full for covered services.

That’s the big difference between network and non-network dentists. Network dentists can’t bill you for the difference between their standard charges and our negotiated fees, and non-network dentists can. Both will charge you for applicable deductibles and coinsurances.

 

Paying for a service from a non-network dentist

If you visit a non-network dentist, you may need to pay the dentist, submit a claim form and get reimbursed by your plan.

 

Do I need an ID card?

When you become covered under the Sun Life Dental plan, you will receive an ID card in the mail. Please show your dentist this ID card, as it contains important information about the network, claim address and toll-free number that the dental office will need for claims submissions.

 

Want to print an ID card?

You can print one anytime – just sign in to My Dental Benefits.

 

Do you have to file a claim for each dental visit?

It depends. Network dentists will file claims on your behalf. A non-network dentist may ask you to complete and submit your own claims.

Download claim forms here

 

Seeing a specialist

With your dental plan, you don’t need a referral to see a specialist. Search for a participating specialist here.

 

Nominating a non-network dentist for participation in your network

If your dentist is not currently participating in the network, you can nominate your dentist by completing our online dentist nomination form. Your dentist may also contact us directly.

 

Predetermination of benefits

If you expect your dental service to cost more than $500, it might be wise to ask your dentist to submit a predetermination of benefits to us to calculate how much of your dental services will be covered. This allows you to know up front what you can expect to pay out of pocket.

 

I want to see the details of my last dentist visit. Where can I go?

See your latest claims and read your EOBs online by signing in to My Dental Benefits. You can even read up on what’s covered and find a network dentist.

Sign in to My Dental Benefits Create an Account

 

Other resources

Learn about your plan and claims
How to read an Explanation of Benefits (EOB)
Contact customer service