TSS - Delta Dental Insurance Program

Delta Dental Insurance Program

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First Published  :Mon Dec 01 00:08:55 GMT 2014
Last Modified  :Thu Oct 19 21:33:08 GMT 2017
Last Published  :Thu Oct 19 21:33:08 GMT 2017
Summary :  Reference for benefits eligible employees who have inquiries about the Delta Dental Insurance Program at Tufts. Audience: Benefits Eligible Employees & Dependents

Response

Primary Information

    Click Post Doc Dental Coverage for Post Doc Dental Information

    Dental Benefits for Faculty/Staff


    Tufts University offers a comprehensive Dental Plan for you and your family members through the Delta Dental Premier USA Plan. You will receive greater benefits when you obtain your dental care from a participating dentist from the Tufts University School of Dental Medicine or in the Delta Dental Premier with National Coverage network, which includes 171,000 dentists.
     
    • Calendar Year Maximum: $1500 per person
    • Preventive and diagnostic services at 100% including one cleaning every six months if you use a Delta Dental dentist. If you get services at Tufts University School of Dental Medicine, you can have up to three cleanings per calendar year.
    • Basic restorative (restorative, oral surgery, periodontics, endodontics, prosthetic maintenance, and emergency dental care) at 80%, after a deductible of $50 per individual, $100 per two-person, or $150 per family, when you use a Delta Dental dentist. If you get your dental care at Tufts University School of Dental Medicine, these services will be covered at 90% with no deductible.
    • Major restorative (prosthodontics and major restorative) at 60%, after a deductible of $50 per individual plan, $100 per two-person, or $150 per family, when you use a Delta Dental dentist. If you get your dental care at Tufts University School of Dental Medicine, these services will be covered at 80%, with the same deductibles as above.
    • Regardless of which dentist you use, orthodontic services are covered at 50% for any age, with a separate lifetime maximum of $1,000.
    • Rollover Maximum: Members can save and accumulate part of their unused benefit dollars from a healthy year and use them for larger, more expensive procedures in the future. Click for details on the Rollover Max program.
     
    Eligibility-
    If you do not enroll within 31 days of the date you are first eligible, you will not be able to enroll until the next annual open enrollment, unless you experience a Qualified Status Change. See Change in Benefits Election after Change in Life Status (Qualified Status Changes.
    All active, regular employees at the University are eligible, provided that you are an exempt or non-exempt employee regularly scheduled to work 17.5 hours or more a week, with a minimum 90 days employment period, or faculty member with at least a half time (as determined by the academic department), two- semester appointment
    See pages 5-8 of the Summary Plan Description for Benefits Eligible Employees for full Eligibility information for Staff, Faculty, Dependents, and Retirees.


    Provider Contact Information
    To find out if your dentist is part of the Delta Premier National network, ask your dentist, call Delta Dental’s customer service department at 1-800-872-0500 or check the Directory of Participating Dentists on Delta’s website at www.deltamass.com.  The Tufts University Delta Dental Group number is 009340-6601.  Delta cards are automatically sent to the home address within 15 days of enrollment.  If a member needs a replacement card, call 800-872-0500 and follow these steps.

    .
    Press 2 for Members/Subscribers
    Press 1 to order a new card
    Press 2 to enter subscriber's SSN, then enter SSN
    Press 1 to confirm SSN, then enter DOB upon prompt
    Press 1 to confirm DOB
    Press 6 to order a new card
    Press 1 to have it mailed to the address on file.  The card will arrive in 2-4 weeks.
     The dental card only issues cards with the subscriber's name on them.  The covered dependent would provide that same card to the dental office and they would be able to verify their coverage using that same member/group ID #'s.

    School of Dental Medicine
    The clinic is located at One Kneeland Street, Boston, MA.
    Call (617) 636-6828 for an appointment.

    EFFECTIVE 1/1/18-
    Employee Discounts – Tufts University School of Dental Medicine Clinics

    A 20% discount off the patient balance after insurance benefits have been applied is available to employees who have dental services provided through the Tufts University School of Dental Medicine Clinics – whether or not you are enrolled in the Delta Dental Plan. This discount does not apply to spouses, domestic partners or dependents who are not Tufts University employees.
    If a dependent child (up to age 26) of a Tufts University employee receives treatment in the School of Dental Medicine Orthodontics Clinic, there is a 20% discount off the patient balance after insurance benefits have been applied – whether or not you are enrolled in the Delta Dental Plan.

    Please see the Dental page on AccessTufts, as well as the Summary Plan Description, for more information on the dental insurance plan offered to eligible employees at Tufts.

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Keywords

    Delta, dental, dentist, dental care, dental benefits, dental insurance, group number, dental rollover, Tufts School of Dental Medicine, post doc dental