Grad Employee Dental Insurance

The Ameritas Fusion dental plan features:
 

  • 100% coverage for preventative care, like exams and up to 4 cleanings/plan year

  • 80% coverage for procedures like fillings

  • 65% coverage for more involved procedures, like crowns

  • TMJ coverage

  • Orthodontic for adults and coverage for children to age 19

  • $2250 calendar year maximum--you can use $150 of this toward vision materials costs on top of your EyeMed vision insurance

  • Reimbursement for out-of-network benefits will be based on the 95th percentile of “reasonable and customary” charges (see description for details).

  • $0 deductible when you see an in-network dentist (a once per year deductible applies for out-of-network providers: $75 for individuals and an aggregate $225 for families.)

 

Please review the plan full description before using insurance.

Benefits plan year is 9/1-8/31 meaning your dental plan year maximum renews each 9/1, as does any responsibility to pay a deductible. 

Who can be covered?

Eligible graduate employees, their dependent spouses, same and opposite sex domestic partners, and children up to age 26. No other family members are eligible for coverage under the plan.

Cost

The dental plan is free for eligible grad employees. Family plans are available with a premium contribution. The Trust Fund subsidizes the cost of the single+1 and family plan to ensure the employee premium is affordable. 

single + 1 plan: (you + a spouse/partner or 1 child): $100/year

family plan: (you + multiple dependents): $100/year

Find a dentist

When prompted, our network is Classic PPO Plus. You can also call Customer Connections department at 800-487-5553.

You should always confirm that your dentist or facility is participating in our network at the time you make your appointment.

Using Benefits Out-of-Network

While you maximize your benefits when seeing an Ameritas dentist, you can still choose to go out-of-network. Reimbursement for your out-of-network benefits are based on the 95th percentile of “reasonable and customary” charges (see description for details). To request out-of-network reimbursement, submit the claim form and attach your receipt from the dental office using the link below.

Using Benefits Outside the US
Submit an Out-of-Network Dental Claim

Should only be necessary if you see an out-of-network dentist. Register on the Ameritas site to submit a claim. 

Click here for the Ameritas Coordination of Benefits Policy.

Using the Fusion Vision Benefit

Your Ameritas dental plan allows you to use up to $150 of your $2250 plan year maximum to reimburse any out-of-pocket vision materials costs not already covered by your EyeMed vision plan. To request a vision reimbursement, submit the claim form and attach your receipt from the vision purchase using the link above. Claims should be submitted within 90 days.  

Pretreatment Estimates

It's important to ask your dentist for a pre-treatment estimate prior to having procedures beyond basic cleanings.  That way, you'll know in advance exactly what portion of the costs your benefits will cover and what you will be required to pay out of pocket.

Benefits Plan Year

The benefit plan year is 9/1 to 8/31, meaning your $2250 plan year maximum renews each 9/1, as well as your deductible responsibility. 

Dental PPE Reimbursement

Some dentists are choosing to charge an extra fee for the cost of their Personal Protective Equipment (PPE) used during your visit. Most dental insurance is not covering PPE fees. The Trust Fund has created a limited, first-come-first-served reimbursement fund to address PPE fees charged to you and not covered by insurance.

 

What documentation is required?

PPE fees are usually coded as D1999 on your Estimate of Benefits (EOB) from Ameritas--the EOB is the preferred way to document this charge for purposes of reimbursement. Alternately, we can accept a bill or letter from your dentist. Either way, to be eligible for reimbursement, documentation must show your name (or the name of an eligible dependent on your plan), date of service, amount paid and designation as PPE not covered by insurance. Please redact all other personal information on your documentation. Log in to your dashboard at hwtrust.geouaw.org to submit your documentation.

 

This reimbursement is completely separate from the wellness reimbursement. Due to the limited pool of funds for this benefit, reimbursement is not guaranteed and is subject to final approval by the Trust Fund Board of Trustees.