| Overview of SHIP dental
coverage |
Dental coverage is included as part of the Student Health Insurance
Plan (SHIP). All UC Berkeley and Mills students enrolled in SHIP
automatically will receive benefits covering preventive and general
restorative dental care.
Metropolitan Life (MetLife) is the dental insurance provider
for SHIP students. Note that dental care is not provided at the
Tang Center. SHIP members can select from a wide choice of local
dentists, listed on the MetLife website.
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| Dental Benefits Summary |
This is a summary of plan benefits. For
a complete list of services that are and are not covered by the
plan, click here.
There is a $1,000 calendar year benefit maximum.
If the care is
provided by a… |
Dentist who is a member of the Preferred
Dentist Program, the plan covers... |
Dentist who is not a member of the Preferred
Dentist Program, the plan covers... |
|
Preventive and Diagnostic Services:
- Oral exams
(2 per year)
- Cleanings
(2 per year)
- X-rays
- Fluoride treatment
|
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 than if you use a MetLife
Preferred Dentist
|
|
| Choosing
a dentist, filing claims, etc. |
Go to MyBenefits
at MetLife.com to choose a dentist and manage your benefits.
- For company name, enter "SHIP."
- To set up your account, click "Register Here" and
follow the instructions.
On MyBenefits 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.
If you have questions or want to speak to a representative,
you may call MetLife at 888-384-5155.
|
| 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 MetLife's Preferred Dentist
Program. With this program, you select a provider from a nationwide
network of over 90,000 participating dentists, 100 of whom are
located within five miles of campus. When you make your appointment,
let the dentist know you have coverage through MetLife.
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 member of MetLife's Preferred Dentist Program, 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 100 dentists within five miles of campus who participate
in the Preferred Dentist Program. To find a dentist, visit the
MetLife website.
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 90,000 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?
Dentists participating in the Preferred Dentist Program will file
a claim directly to MetLife. 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 in the Preferred Dentist
Program, you may need to pay all charges, then file a claim for
reimbursement. You may print out a claim form from the MetLife
website, or call 1-888-384-5155 to have one sent to you. |
| |
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 SHIP, you automatically receive dental
coverage. You cannot enroll in or waive dental coverage separately
from 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 MetLife website
to:
- Learn more about the Preferred Dentist 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 MetLife at 1-888-384-5155 to speak to a dental
plan representative.
|
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