Primecare Dental Plan
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For more than 8 years now, Primecare Dental has been a valuable resource for high quality, and affordable consumer-driven dental benefit plans for individuals, seniors, employers, municipalities, unions and insurance agents in 42 counties across California.

We’ve developed fully licensed and regulated dental plans for members offering broad benefits with deep savings. Our dental plans offer complete and comprehensive benefit coverage including diagnostic, preventative, major and specialty services.

We are the first DHMO approved by the California Department of Managed Healthcare to offer benefits for dental Implants, Veneers, Lumineers, sedation, and complete cosmetic specialties. Our network of over 3,700 contracted general and specialist dentists are located throughout California and cover every area of dental treatment.

Primecare pioneered underwriting standards that reset client premiums back to the levels originally offered before annual, trended renewals were applied. This allows us to offer clients deeper premium savings over our competitors. These premiums are further enhanced with multiple year premium guarantees for our clients.

We offer single-source administration with simplified billing, customized reporting and streamlined administration all guaranteed throughout the contract term and integrated electronically. Our dental HMO plans are 100% voluntary, and are a great solution for self-insured or fully-insured benefit plans.

 

Programs offered Include:

  • Commercial employer dental benefit plans.
  • Individual, consumer-driven dental benefit plans.
  • A financially binding reimbursement model based on capitation, a system that retains quality care and controls the reimbursement expenses of the plan, patient and dentist.
  • A proven method for building provider networks that select, manage and audit the finest dentists available under contract.
  • A proprietary utilization management system that monitors and reviews appropriateness and necessity of dental care, ensuring the highest level of treatment in the most affordable setting for the plan, patient and dentist.
  • A management team with extensive experience in the delivery of dental benefits.
Primecare Dental recognized long ago the need to structure dental managed care benefit programs to meet the new demands of the market. Primecare currently offers more than 10 licensed plans that offer benefits on more than 300 dental procedures varying in cost and copayment. Common features in Primecare dental plans include:
  • Low premiums and substantial savings.
  • No waiting periods for any treatment.
  • No deductible to meet.
  • No maximum dollar limit.
  • No claim forms.
  • No pre-existing condition clauses.
  • Complete specialty treatment coverage.
  • All providers meet the plan’s rigorous quality assurance standards.
  • Professional member services department.

 

Individual and Family Dental Plans

Primecare’s individual dental plans are packed with features and as a stand-alone solution can be purchased independent of any other benefit plan. These plans provide affordable care through a network of highly qualified dentists. There are no waiting periods, calendar year maximums, or deductibles and no claim forms. Each enrolled family member may choose their own dentist from the Primecare directory, and the plans are comprehensive, covering more procedures than many other dental benefits plans available.

These plans are perfect for the self-employed, part-time employee, or those without an opportunity to participate in any other dental benefit program such as seniors and cash paying consumers.

 

Employer Group and Association Dental Plans

Primecare’s employer group dental plans emphasize preventive care and early dental disease detection. Employees receive greater benefits at a lower premium from credentialed network dentists with no set plan maximums, deductibles or claim forms.

Primecare’s group plans are offered on an employer paid or voluntary basis without contributing to its cost. Employers can choose to pay any, or the entire low monthly premium. There are minimal participation requirements so employers don’t have to worry if only a few employees enroll. There are no pre-existing condition limitations. No employee will be refused coverage. Primecare offers a wide range of managed care dental plans covering all general and specialist dentistry needs for employer groups of all sizes.

 

Complaints and Disputes

The California Department of Managed Health Care is responsible for regulating health care service plans. The Department has a toll-free telephone number (1-888-HMO-2219) to receive complaints regarding health plans. The hearing and speech impaired may use the California Relay Service's toll-free telephone numbers (1-877-688-9891 (TTY) or 1-916-229-0465 (FAX) to contact the Department. The Department's internet website (http://www.hmohelp.ca.gov) has complaint forms and instructions online. If you have a grievance against your health plan, you should first telephone your plan at 1-800-937-3400 and use the plan's grievance process before contacting the Health Plan Division. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your plan, or a grievance that has remained unresolved for more than 30 days, you may call the Department for assistance. The plan's grievance process and the Department's complaint review process are in addition to any other dispute resolution procedures that may be available to you, and your failure to use these processes does not preclude your use of any other remedy provided by law.

A complaint form as well as a copy of the grievance form for handling member complaints is available at the address above or from the member’s panel dental office. Any unresolved grievances will be settled by arbitration.

Any complaint or dispute should be directed to Primecare Dental Plan at:

10604 Trademark Parkway, Suite 310
Rancho Cucamonga, Ca. 91730

 

Grievance

To submit a Grievance form. Click Here.

 

Contact Primecare Dental Today

Service Representatives are standing to assist you in enrolling in Primecare Dental. For a complete list of our dental plans and premiums please contact us at 1.800.937.3400.

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