2018 NUSS - Dental Coverage

EmblemHealth Preferred Dental Benefits Plan A (“EmblemHealth”)

The EmblemHealth Preferred Dental Benefits Plan A (“EmblemHealth Dental”) covers preventive, basic and major services. You may choose to use participating EmblemHealth dentists or go to a nonparticipating dentist.
 
When you receive care from a nonparticipating dentist, you pay the provider up front, and then file a claim for reimbursement. You’ll be reimbursed up to the allowance shown on the EmblemHealth Dental fee schedule for covered services, which is available from EmblemHealth. If you use a participating dentist, no forms are required.
 
For a listing of EmblemHealth dentists, go to: www.emblemhealth.com/find-a-doctor/ directory and select “Dental Preferred” from the menu. Then, enter your location to search for participating providers nearby. For more information, call EmblemHealth at 212-501-4443.
 
If you use a nonparticipating dentist, you may have to pay the difference between the total cost and the amount the Plan pays.
 

 

EmblemHealth Dental Plan Overview
BenefitIn-NetworkOut-of-Network
Preventive and Diagnostic Services: 
Examinations, cleanings, X-rays, 
fluoride treatments,** space maintainers**
 
100%Reimbursement is subject to 
established plan schedule.
Basic Services: Extractions, root canals, 
gum disease, oral surgery, anesthesia, 
pain relief, denture repair, tests, lab exams
100%Reimbursement is subject to 
established plan schedule.
Major Services: Dentures, crowns100%Reimbursement is subject to 
established plan schedule.
Maximum Annual Benefitunlimited

** For dependent children only.

 

Your Monthly Cost for EmblemHealth Dental
Full-Time
Yourself$0
Family*$0
Part-Time
Yourself$8.96
Family*$28.71

* Dependent children can only be covered for Dental through the end of the
calendar year in which they turn 19.

 


Aetna Columbia Dental Plan

The Aetna Columbia Dental Plan provides you with the flexibility to see Columbia University College of Dental Medicine faculty and alumni, called the Columbia Preferred Dental Network, along with the national Aetna PPO network of dentists, all under one comprehensive program. You may also see a dentist outside of the network, although your cost will be significantly higher whenever you use out-of-network dentists.
 

 

Aetna Columbia Dental Plan Overview
BenefitColumbia Preferred  Dental NetworkAetna Dental NetworkOut-of-Network*
Preventive Care: Includes routine cleanings, routine exams and X-rays100%100%100%
Basic Restorative Care: Includes fillings and extractions100%80%80%
Major Restorative Care: Includes crowns, root canals, bridges and dentures60%50%50%
Orthodontia for Adults & Children50%50%50%
Annual Deductible (per person)none$25$25
Annual Maximum Benefit (per person)$1,500$1,250$1,250
Orthodontic Lifetime Maximum (per person)$1,500$1,250$1,250

Important Information* The percentage paid by Aetna Dental is limited to the network-negotiated fees. This means if you use an out-of-network dentist, your reimbursement will be based on the network fees for the services provided. For example, if your dentist bills you $800 for a crown but the network-negotiated fee is $400, you will be reimbursed for 50% of $400 (the network-negotiated fee) totaling $200. You are responsible for paying the balance of $600 to your out-of-network dentist.

 

2018 Monthly Pre-Tax Contributions for Dental
Yourself$27
You Plus One$68
Family$109

 

Using the Columbia Preferred Dental Network

Preferred Dental Network When you use a dentist who participates in the Columbia University network, you receive a greater benefit for services. To locate a Columbia Preferred dentist, see Benefits Vendor Contacts. Columbia Preferred dentists are located throughout the tristate area of New York, New Jersey and Connecticut.

Columbia Preferred dentists accept reimbursement for services covered at 100% as payment in full. You are not responsible for paying any fees that exceed the network-negotiated fees. You also do not have to submit any claim forms when you use a network participating dentist.

DENTAL ID CARDS
Aetna will not mail you an ID card after you enroll. Instead, they will mail you a letter confirming your enrollment. When you go to the dentist, you can show the office a copy of that letter, or tell the office your name, date of birth and Member ID# (or your Social Security Number). If you prefer to have an ID card, sign up on Aetna's member website at www.aetna.com to print out a card for you and your dependents.

 

 

Columbia Preferred Dental Plan Facilities
cudentalassociates.columbia.edu
Columbia Dental Associates
Morningside Associates 

1244 Amsterdam Avenue (near 121st Street)
New York, NY  10027
212-961-1266
 
and
 
430 West 116th Street
New York, NY  10027
212-662-4887
 
Columbia Dental Associates
Medical Center Practice  

Bard Haven Towers 1
00 Haven Avenue
New York, NY  10032
212-342-0107
Columbia-Presbyterian
Eastside Dental Faculty Practice
Columbia Doctors 

Midtown 51 West 51st Street Suite 350
New York, NY  10019
212-326-8520
 
Columbia Oral & Maxillofacial Surgery
Vanderbilt Clinic 

622 West 168th Street
7th Floor
New York, NY  10032
212-305-4552