Dental Care
Eligible students, scholars and dependents are automatically enrolled in the dental plan, provided they are covered under the UC Student Insurance Plan (UC SHIP). If covered, enrollees are eligible to receive care at the in-network Student Clinic (only) at the UCSF School of Dentistry, which is part of the Delta Dental network. Care received in the faculty practice is out-of-network.
Policy Numbers & Network
| Billing | Enrollee ID | Group Policy | Network |
|
Delta Dental of California |
Download it (on the My Health tab) or call to get it: 1-800-853-5899 |
4633 | Delta Dental 1-800-765-6003 |
Insurance Benefits
| Annual Deductible: | $25 in-network / $50 out-of-network |
| Annual Maximum Benefit: | $1000 in-network / $750 out-of-network |
| Diagnostic & Preventative Services: | 100% in-network / 80% out-of-network |
| Basic Services: | 80% in-network / 60% out-of-network |
| Crowns and Cast Restoration Services: | 50% in-network / 40% out-of-network |
| Prosthodontics: | 50% in-network / 40% out-of-network |
| *Limitations or waiting periods may apply for some benefits; some services may be excluded. Please refer to your Evidence of Coverage (coming soon!) or Summary Plan Description (coming soon!) for waiting periods and a list of benefit limitations and exclusions. | |
| **Fees are based on PPO fees for in-network dentists and the maximum plan allowance (MPA) for out-of-network dentists. Reimbursement is paid on Delta Dental contract allowances and not necessarily each dentist's actual fees. | |
Insurance Brochure
Please refer to the Delta Dental Benefits Brochure or the UC SHIP Dental Website for details.
