Frequently Asked Questions

Find answers to commonly asked questions about our dental plans. If you can’t find the answer to your question here, please contact our Customer Service team at (808) 529-9248 or call toll-free at 1-844-379-4325.

Category

Why should I choose an HDS participating dentist?

There are three reasons why we encourage our members to seek dental services from an HDS participating dentist. More than 95 percent of all licensed, practicing dentists in Hawaii participate with HDS. To find a participating dentist, click here.

 

Save Money

HDS participating dentists have agreed to accept a discounted rate (eligible fee) as payment in full for services to our members unlike a non-participating dentist who can charge you any amount. See example below.

 


FOR EXAMPLE PURPOSES ONLY

Retail Amount for Services

HDS Participating Discounted/ Eligible Fee

Non-
Participating
Eligible Fee

HDS Benefit

HDS Pays

Member Owes

Participating
Dentist

150.00

100.00

 

80%

80.00

 $20
($100-80) 

Non-
Participating
Dentist

150.00

 

75.00

80%

60.00

 $90
($150-60) 

 

Participating dentists agree to processing policies and are prohibited from billing and collecting fees in excess of the agreed upon schedule even in the event you exceed your annual plan maximum. Non-participating dentists will continue to charge the full retail rate. You may visit any dentist, but visiting a participating dentist offers you additional savings. 

 

Pay Copayment Only

Because HDS pays the participating dentist directly, the dentist will only bill you for the difference between the eligible fee and the amount HDS is expected to pay. A non-participating dentist may require that you pay the retail amount of all services in advance.  

 

HDS Credentials Participating Dentists

HDS credentials all participating dentists and has an ongoing audit program for fraud and abuse. None of these controls apply to non-participating dentists.
 

What can I do if I am not satisfied with a dentist’s service?

If an HDS member is not satisfied with a service performed by an HDS participating dentist, we recommend that the member contact the dentist and explain the reason for dissatisfaction. If the member does not want to speak with the dentist, we suggest that the member write a letter to the dentist and provide a copy to HDS. If the dentist’s response is not satisfactory, the member can request that HDS follow up and attempt to resolve the matter. The member may also file a complaint with the Hawaii State Department of Commerce & Consumer Affairs' RICO Consumer Resource Center by calling 586-2653.

Can I see a dentist on the Mainland and still be covered by my HDS plan?

Yes, whether it’s an emergency or regular visit, your HDS plan covers you while on the Mainland as long as you receive services from a Delta Dental participating dentist. To find a Delta Dental participating dentist near you, click here, select “Delta Dental Premier” as your dental plan and search for a dentist.

 

Be sure to present your HDS/Delta Dental membership card on your first visit to the dentist. You can print your membership card from the HDS website. Log in at the top left of this page and go to “Members,” then “Membership Card.”

HDS Dentist Network

Are at home invisible aligners or do-it-yourself (DIY) orthodontic treatment systems covered by HDS?

While these alternatives may seem like a quick, convenient, and cost-effective way to straighten your teeth, re-aligning your teeth is a complex and dynamic process that changes your bone and gum structure in your mouth. If not done correctly by a trained professional in designing, executing and overseeing your teeth straightening process that often takes several months and in most cases years, problems may occur down the road. For these reasons, to help protect you and your family from unforeseen consequences, orthodontic DIY treatments are not a covered benefit.

Does HDS require prior authorization for any covered dental services?

HDS does not require prior authorization for any covered dental services. If you are concerned about coverage or the cost of a service, you may submit a request for a preauthorization to obtain coverage information and an estimated benefit amount.

Why do I have to pay more for white fillings on my back teeth?

HDS plans cover white (composite) fillings on the front teeth and silver (amalgam) fillings on the back teeth. If you and your dentist determine that white fillings are preferable on your back teeth, HDS will allow you to use the amount HDS would have paid for a silver filling towards the amount your dentist charges for a white filling. You will have to pay the difference between your dentist’s retail charge for the white filling and the amount paid by HDS for a silver filling.

What is a plan maximum?

The plan maximum is the total amount that HDS will pay for a member’s dental services during a specified period. Normally, a plan maximum follows a 12-month calendar year from January to December, but the plan maximum period can begin in any month and some plan maximum periods are shorter or longer than 12 months.

How is tax calculated on my dental services?

Your dentist calculates the tax on dental services. Tax is not an HDS plan benefit. Please discuss the calculation of taxes with your dentist.

Are silver fillings (amalgam) dangerous to my health?

HDS is aware that the issue of dental amalgam has been in the news due to publicity surrounding groups concerned about risks associated with exposure to mercury. The American Dental Association states that dental amalgam remains a safe, affordable and durable cavity filling choice for patients. HDS members who are concerned about the safety of amalgam should consult with their dentist.

Why does the dentist do a procedure if it is not a covered benefit?

HDS dental benefit plans include coverage for designated benefits as specified in the dental contract or brochure. Other services may be necessary and recommended by your dentist. The fact that the services are not covered by HDS does not indicate that they are not clinically necessary.

I just changed from one HDS plan to another. Why do I have a wait period with my new plan?

Each employer determines the parameters of the dental benefit plan offered to its employees. In some cases, in order to reduce the cost of the plan, an employer group elects to have a wait period before certain major services are benefited. However, no wait periods apply to diagnostic and preventive services such as cleanings, exams, fluoride treatments and X-rays.

Benefits

As an Employer Group, what options do we have to make payments?

Employer Groups can make payments in several ways:

  • Online – log on to our Employer website to make a one-time payment from a bank account
  • Recurring automatic payments – complete the form on our Employer website
  • Mail – send a check or money order with your invoice Remittance Advice to:
    Hawaii Dental Service
    P.O. Box 30500
    Honolulu, HI 96820-0500
  • Cash – hand-delivered payments are accepted at our office at 700 Bishop St. Ste. 700, Honolulu, HI. We are open Monday-Friday, 8 am to 4:30 pm.

If you have questions, please contact the Billing Department at 529-9285 or toll free at 1-844-379-4326.

As an individual plan member, what is a grace period and what happens to my claims during this period?

You are required to pay your premium by the scheduled due date. For each premium payment after your initial premium payment, a grace period will apply. A grace period is a time period when your plan will not terminate even though you did not pay your premium. HDS provides a general 30-day grace period before your coverage will be canceled. If you receive federal Advance Premium Tax Credits for the dental plan through HealthCare.gov, you have a 90-day grace period before HDS terminates your plan due to non-payment. HDS will pay claims for covered services that are properly submitted during the first 30 days of that grace period. During the unpaid 31st through 90th day of the grace period, HDS will not pay for any claims that you incur. If you pay your full outstanding premium before the end of the 90-day grace period, HDS will pay all claims for covered services that are properly submitted for the 31st through 90th day of the grace period. Claims may be resubmitted by the dentist and will be reprocessed according to the enrollment status provided that it is received no later than 12 months from the date of service. If you do not pay all of your outstanding premium by the end of the 90-day grace period, your coverage will terminate, and HDS will not pay for any claims submitted for you during the 31st through 90th days of the grace period. Your provider may balance bill you for those services.

Billing and Payment