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Dental

To enhance your existing coverage, select dentists have agreed to help students by providing savings on certain plan eligible services. In order to access the select savings you must present your myBenefits Card each visit.

NOTE TO STUDENT: Dentists are not restricted to the fee guide the insurance company uses. Therefore, total coverage may not be exactly as shown.

Insured
Portion*

Dental
Partner
Savings

Total
Coverage

Diagnostic and Preventative
• annual exam**

80%

20%

100%

Minor Restorative
• fillings, denture adjustment & repairs

80%

20%

100%

Extractions
• limited to 4 teeth per patient per benefit year

50%-75%

20%

70%-95%

Endodontic & Periodontic
• root canals

50%

20%

70%

Major Restorative
• crowns, bridges and dentures
(excludes orthodontics)

15%

20%

35%

Benefit year maximum of $750 and specific limits may also apply.
Pre-approval required for treatment plan exceeding $300.

* The Insured portion is based on the insurer's current eligible fee. The Dental Partner Savings is based on the dentists' fees. Since the dentist is not restricted to the insurer's fees, if the dentist's fee's exceed the amount eligible from the insurer, than the total coverage (after the savings provided) may differ. Dental Partner Savings is not applicable to laboratory fees.

** Exam includes: diagnosis, x-rays, two units of scaling and one unit of polishing. Limited to once per benefit year.

To take advantage of the savings brought to you by your student organization, use "Find a Practitioner" to access a Select Dental Partner in your area.

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