Students

Dental Coverage, Fall 2011 - Spring 2012

 

dentalDental coverage is included as part of the UC Student Health Insurance Plan (UC UC SHIP). All UC Berkeley students enrolled in UC UC SHIP automatically will receive benefits covering preventive and general restorative dental care.

Delta Dental is the dental insurance provider for UC SHIP students. Note that dental care is not provided at the Tang Center. UC SHIP members can select from a wide choice of local dentists, listed on the Delta Dental website.

 

Group and ID Numbers Delta Dental UC SHIP Group plan numbers: Undergraduates 5364; Graduates 4633.
Your customer number is the same as the ID number on your Anthem Blue Cross card.
Dental Benefits Summary There is a $1,000 academic year benefit maximum (August 15-August 14).
If the care is
provided by a…		 Dentist who is an in-network PPO dentist the plan covers… Dentist who is not an in-network PPO dentist the plan covers…
Preventive and Diagnostic Services:
  • Oral exams
    (2 per year)
  • Cleanings
    (2 per year)
  • Fluoride treatment
  • X-ray Bitewing (once per year)
  • X-ray Full mouth (once every 5 years)
100%
of negotiated fees that participating dentists have agreed to accept as payment in full
80%
of reasonable and customary charges
Basic Operative and Restorative Services:
  • Fillings
  • Simple extractions
  • Oral surgery
  • Periodontics
  • Endodontics
80%
of negotiated fees after a $25 annual deductible
60%
of reasonable and customary charges after a $25 annual deductible.
Co-payments will be higher with non-Network providers than if you use an in-Network Delta Dental PPO dentist
Major Services
  • Prosthodontics
  • Inlays/onlays
  • Crowns & cast restorations
  • Implants
50%
of negotiated fees after a $25 annual deductible
40%
of reasonable and customary charges after a $25 annual deductible.
Co-payments will be higher with non-Network providers than if you use an in-Network Delta Dental PPO dentist
Benefits NOT covered
  • Maxillofacial prosthetics
  • Orthodontics
Choosing a dentist, filing claims, etc. Go to http://deltadentalins.com/UCB/ to choose a dentist and manage your benefits.
  • To set up your account, click "Register Here" and follow the instructions.

On the Delta Dental UC Berkeley 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 (888)335-8227.
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?
 

How does the dental plan work?
Dental coverage is provided through the Delta Dental PPO plan. With this plan you select a provider from a nationwide network of over 100,000 participating dentists, over 100 of whom are located within five miles of campus. 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.
 

How do I find a dentist?
There are over 100 dentists within five miles of campus who participate in the Preferred Dentist Program. To find a dentist, visit http://deltadentalins.com/UCB/. You can even print directions and a map to the office!

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.
  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/UCB/, or call (888)335-8227 to have one sent to you.

To assist with filing a claim, your dentist may ask for the plan group number:
Group plan numbers | Undergraduates: 5364 Graduates: 4633.
Your customer number is the same as the ID number on your Anthem Blue Cross card.

  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.
  Can I waive the dental plan?

Dental coverage is available as part of the 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.
 

What if I have more questions?

For more information about the Student Health Insurance Plan and dental coverage, call the Student Health Insurance Office at (510)642-5700.

Visit the http://deltadentalins.com/UCB/ website to:

  • Learn more about the Delta Dental PPO Dental program
  • 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 that Explanation of Benefits be sent you via e-mail
  • Download claim forms
  • Read answers to other frequently asked questions, such as how to interpret the Explanation of Benefits form.

You may also call Delta Dental at (888)335-8227 to speak to a dental plan representative.

Back to UC SHIP home page>