Q. Who is eligible for pediatric dental benefits?
Anyone under the age of 19 enrolled in an Individual/Family Neighborhood plan is eligible for pediatric dental benefits.
Q. Do I have to pay more for the pediatric dental benefit?
These services are offered as part of the Neighborhood benefit plan. There is no additional monthly premium cost for these services. Member cost-sharing and benefit limits may apply. Please see the certificate of coverage at nhpri.org for more information.
Q. Is the dental out-of-pocket (OOP) maximum combined with the medical OOP maximum?
Yes. Once a member reaches their combined medical and pediatric dental OOP, benefits will be paid at 100% for the rest of the calendar year.
Q. Who do I contact if the information on my membership card is incorrect?
Contact Neighborhood Health Plan of Rhode Island at 1-855-321-9244 (for TTY services, dial 711) if corrections are required.
Q. How can I see my plan benefits?
See complete details about your dental coverage when you set up an online account. Once you register, you can view a comprehensive breakdown of your benefits, including the following details:
You can also print or order a new ID card, check the status of a claim in progress and more.
Q. How can I find out if my dentist participates?
In Rhode Island, nine out of 10 dentists participate in the Delta Dental network so chances are your dentist already participates. In addition, you'll have access to the nation's largest network of dentists. The Delta Dental Premier® program encompasses more than 155,000 dentists and more than 348,000 office locations.
To find out if your dentist participates, click here .