Member FAQ

Q. Where do I mail a claim?
A. Mail claims to:
Mutual of Omaha
Attn: Claims Department
PO Box 6560
Sherwood, AR 72124

Q. Where can I get information about my benefits?
A. Your company’s coverage information is found in your membership certificate booklet which is provided to you by Mutual of Omaha; Or, call Customer Service at 1-877-999-2330. You can also view the booklet online.

Q. How can I tell what I owe for dental services?
A. The amount that you owe will be detailed on the Explanation of Benefits that you will receive by mail. You may also access your Explanation of Benefits when you log in to the secure member homepage of this web site.

Q. How will I get reimbursed?
A. An in-network dentist will file your claim directly and be reimbursed directly by us. You may be responsible for any co-insurance, co-payment, and/or deductible due the dentist. If you choose to visit a non-participating dentist, you may be responsible for all payments and charges to the dentist at the time of treatment. You may also be responsible for submitting the claim form to us. In most cases, we will send you reimbursement for the covered services. Claim forms can be printed from this web site under the Subscriber Connection/Claim Form.

Q. Do I need pre-approval for major dental work?
A. We do not require a pre-approval for services received, but we recommend a predetermination of the claim for any non-emergency treatment plan of $300 or more. This allows us to let you and your provider know, before the procedure is performed, if it is a covered procedure and what the reimbursement for the covered procedure will be. This helps eliminate confusion before dental work is undergone. Please discuss this option with your dentist.

Q. Does my plan cover cosmetic dentistry and orthodontics?
A. Cosmetic services are not covered under Mutual of Omaha's group dental plans. Orthodontia is a benefit option that is offered as a service under many plan options. Please review your group’s Membership Certificate booklet to see if this is available under your plan. You may also contact our Customer Services Department at 1-877-999-2330 to review your group’s dental benefits.

Q. What if I am unhappy with the dental care I received or wish to file a grievance?
A. You are welcome to file a complaint with Mutual of Omaha concerning any quality of care issues you may have. Please detail your complaint in writing and mail to:
Mutual of Omaha
Attn: Benefit Services
PO Box 6560
Sherwood, AR 72124

Q. How do I find a Mutual of Omaha participating dentist or check to see if my current dentist is a Mutual of Omaha participating dentist?
A. You can view a listing of participating dentists online by visiting the Find a Dentist section under the Subscriber Connection of this web site. You can also call our Customer Services Department at 1-877-999-2330.

Q. What are the advantages of visiting a participating dentist?
A. The main advantage is the cost savings to you. Our network dentists have agreed to accept our allowances as payment in full for the services provided under your plan. Another advantage is that a participating dental office will file all claims for you and we will pay the dentist directly. You are only responsible for any deductible, co-insurance or co-payment at the time of your visit.

Q. My dentist is not a participating dentist. Can I still visit him or her?
A. Yes, under our plans you have the freedom of choice. Seeing an out of network dentist will potentially be more costly because they have not agreed to accept our payment allowances. You will be responsible for the difference between what your Mutual of Omaha plan covers and what the non-participating dentist charges.

Q. How do I change dentists?
A. Under our plans you simply make an appointment with your new dentist of choice.

Q. Do I need to submit a claim after receiving treatment or will my dentist handle it?
A. If you receive treatment from a participating dentist, they will file all claim information for you. However, you may responsible for submitting claim information if you visit a non-participating dentist. Your employer should be able to provide you with a claim form or you can print one from our web site at Mutual of Claim forms should be mailed to:
Mutual of Omaha
Attn: Claims Department
PO Box 6560
Sherwood, AR 72124

Q. Where can I submit a change of address ?
A. Inform your Human Resources/Benefits Department of your new information.

Q. I've recently married. How do I add my new spouse to my plan?
A. Contact your Human Resources/Benefits Department and inform your employer that you would like to add a dependent to your coverage.

Q. What is a predetermination?
A. A predetermination is a plan of treatment completed by your dentist for services that will be provided at a future date. You and your dentist will receive a reply as to whether the treatment plan is covered under your group’s benefits. You will also receive an estimated dollar amount that your plan will cover for the planned procedure. A predetermination is recommended when dental services are expected to cost $300 or more. A predetermination is valid 12 months from issue date, and is subject to eligibility, benefit maximums, coordination of benefits (if applicable) and group and dentist status at the time services are provided.