The university offers two dental care plan options with Delta Dental of New York:
The Delta Dental PPO Plus Premier Plan gives you the flexibility to use providers who participate in the Delta Dental PPO or Delta Dental Premier Networks (in-network) or providers who do not participate in the Delta Dental networks (out-of-network). To search for in-network providers, go to www.deltadentalins.com (the networks are Delta Dental PPO and Delta Dental Premier). You must pay at point of service and file a claim form for any services provided by an out-of-network dentist. To obtain a Dental Reimbursement Claim form, go to benefits forms and documents.
You and your enrolled dependents (if any) are eligible for dental examination and basic cleaning twice a year (not to exceed once in every six month period). There is no deductible charge for diagnostic and preventive services (i.e., exams, x-rays, and cleanings). All other covered dental procedures are subject to an annual per person deductible of $50, with a maximum family deductible of $150 (this applies to both in- and out-of-network services). The maximum annual benefit per person is $1,750. For more information, refer to the Delta Dental PPO Plan Summary (PDF) and the Evidence of Coverage (PDF).
You can contact Delta Dental PPO (group number 02019) at 800.932.0783 for more information.
The DeltaCare USA (DHMO) Plan offers in-network coverage only. You must select an in-network Primary Dentist when you enroll in the plan and obtain referrals from your primary dentist to see specialists. Please note that the in-network providers associated with this plan are in New York, New Jersey, and Pennsylvania only. To search for in-network providers, go to www.deltadentalins.com and search the DeltaCare USA network. You can change your designated Primary Dentist at any time by calling Delta Dental at 800.422.4234 (group number 70694). There is no plan deductible or a maximum annual benefit on the DHMO plan. For more information on this plan refer to the DeltaCare USA (DHMO) Information Summary and Benefit Description (PDF).
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Benefits Forms and Documents
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