Dental Benefits Summary
2011/12
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There is a $1,000 academic year benefit maximum.
If the care is
provided by a … |
Dentist at SH, or an in-network PPO dentist the plan covers… |
Dentist who is not at SH or an in-network PPO dentist the plan covers… |
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Preventive and Diagnostic Services:
- Cleanings
(2 per year)
- Fluoride treatment
- X-ray Bitewing (once a year)
- X-ray Full mouth (once every 5 years)
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100%
of negotiated fees that participating dentists have agreed to accept as payment in full
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80%
of reasonable and customary charges
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Basic Operative and Restorative Services:
- Fillings
- Simple extractions
- Oral surgery
- Periodontics
- Endodontics
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80%
of negotiated fees after a $25 annual deductible
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60%
of reasonable and customary charges after a $25 annual deductible Co-payments will be higher than if you use an in-network Delta Dental PPO dentist
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Crowns, Other Cast Restorations -
Crowns, inlays, onlays and cast restorations
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*50% - 2011/12
*70% - 2012/13
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40% |
Prosthodontics -
Bridges, partial dentures, or full dentures
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*50% - 2011/12
*70% - 2012/13
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40% |
Maximum per year
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$1,000 |
$750 |
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| Choosing a dentist, filing claims, etc. |
Go to Delta Dental website to choose a dentist and manage your benefits.
- To set up your account, click "Register Here" and follow the instructions.
On the Delta Dental website you can:
- Choose a dentist and print a map to the dentist's office
- Check the status of your claims, including tracking your deductibles and year-to-date claims payments
- Request e-mail notification when claims are processed
- Download claim forms
- Read answers to frequently asked questions, such as how to interpret the Explanation of Benefits form
- Find fees
If you have questions or want to speak to a representative, you may call Delta Dental at (800) 765-6003.
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| Frequently Asked Questions About Dental Coverage |
How does the dental plan work?
How do I find a dentist?
Do I need to file a claim after my visit?
Can I find out how much services will cost prior to treatment?
Can I waive the dental plan?
What if I have more questions? |
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How does the dental plan work?
Dental coverage is provided through the Delta Dental PPO plan. With this plan you can come to the SH Dental Care Center or select a provider from a nationwide network of over 100,000 participating dentists. When you make your appointment, let the dentist know you have coverage through Delta Dental.
You do not need to pre-select a primary dentist, carry an ID card or receive referrals for specialty care. If you visit a dentist who is not a Delta Dental PPO dentist, you still will receive benefits, but you will be charged higher out-of-pocket co-payments for the services you receive.
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How do I find a dentist?
If you need dental care when away from campus, you may choose from over 100,000 dentists nationwide. You have the freedom to choose any dentist at any time. You do not need to visit the same dentist every time.
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Do I need to file a claim after my visit?
Delta Dental PPO dentists will file a claim directly to Delta Dental. If you are responsible for any portion of the charges, you will be expected to pay that amount at the time of service. If you visit a dentist who is not a Delta Dental PPO dentist, you may need to pay all charges, then file a claim for reimbursement. You may print out a claim form at http://deltadentalins.com/UCSB/, or call 1-800-765-6003 to have one sent to you.
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Can I find out how much services will cost prior to treatment?
Yes. You may have your dentist request a pretreatment estimate to determine what services the plan will cover and at what payment level. We strongly recommend a pretreatment estimate if the services are expected to cost more than $200. With the pretreatment estimate, you'll know exactly what your payment responsibilities are and can discuss treatment options with your dentist.
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Can I waive the dental plan?
No. Dental coverage is available as part of the UC Student Health Insurance Plan. If you are enrolled in UC SHIP, you automatically receive dental coverage. You cannot enroll in or waive dental coverage separately from UC SHIP.
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What if I have more questions?
For more information about the UC Student Health Insurance Dental Plan and coverage, call the SH Insurance Office at (805) 893-2592 or visit the Delta Dental website
You may also call Delta Dental at (800) 765-6003 to speak to a dental plan representative.
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