My Dental Coverage

You can receive care at the dentist of your choice, but you will pay less by seeing Delta Dental PPO dentists. Plus, you get regular cleanings and checkups with a Delta Dental PPO dentist for no cost. Check out the Delta Dental guide to help you get the most from your plan.

Three steps to getting dental care

  1. Register for the Delta Dental app. To register, download the Delta Dental app available on the Apple App Store or on Android Google Play or go to the Delta Dental website. At the bottom of the “Online Services” box on the right, click Register Today. If you are a UC Santa Barbara student, you can access your dental care on the Delta Dental website for UCSB.
  2. Find a dentist and estimate your costs. Once you register, you can select a dentist online from the Delta Dental PPO network, by phone through Delta Dental Customer Service at (800) 765-6003, or through the mobile app. You can also use the Dental Care Cost Estimator tool online and on the app to find estimated cost ranges for common dental care needs.

Tip! Delta Dental has many different types of networks available, so be sure you select a dentist from the Delta Dental PPO network. If you go to a dentist belonging to another Delta Dental network, like Delta Dental Premier, your costs will be higher.

Note for UC Irvine, UC Riverside and UC Santa Barbara students: Your campus offers a convenient on-site dental clinic when you need dental care.

  1. Take your ID card. You will need to show your Delta Dental ID card when you go for care. Download the Delta Dental app available on the Apple App Store or on Android Google Play  or the StudentHealth app available on the Apple App Store or on Android Google Play so you will have your ID card with you wherever you take your phone. You can also print a temporary ID card online, or order a permanent ID card replacement.

Your UC SHIP dental benefits

The Delta Dental Preferred Provider Organization (PPO) network pays a certain amount toward different types of treatments. Delta Dental PPO providers have agreed to that fee schedule, but out-of-network providers have not. If your out-of-network dentist charges more than what UC SHIP covers for your dental service, you will need to pay the difference. Find complete plan details in the Combined Evidence of Coverage and Disclosure Form. The Evidence of Coverage Form is available in English or in Spanish.

Dental Benefits

All campuses except Santa Barbara

The chart below highlights what UC SHIP covers and how much you pay for services. Except for preventive care, you will pay a deductible for services you receive. After you meet the deductible, the plan will pay a portion of the cost. Certain expenses and services are excluded from coverage.

 

Delta Dental PPO Network

Other Delta Dental Networks or Out-of-Network

Annual deductible

Preventive and diagnostic services: $0

Other services: $25 per person

Preventive and diagnostic services: $0

Other services: $50 per person

Annual benefit maximums

$1,000 per member, not to exceed a cumulative maximum of $1,000 each benefit year for network plus out-of-network dental benefits in total

$750 per member, not to exceed a cumulative maximum of $1,000 each benefit year for network plus out-of-network dental benefits in total

Fee schedule

PPO providers agree to accept the Delta Dental PPO maximum allowed fee schedule.

You are responsible for the difference between the amount Delta Dental pays and the amount your out-of-network dentist bills.

See note about cost difference below.*

Preventive and diagnostic services

Includes oral exams; cleanings (twice every 12 months); X-rays (one bitewing series within 12 months); fluoride treatment

$0

20%

Basic services

Includes fillings and extractions; composite fillings on back teeth; endodontics (root canals); periodontics; oral surgery; night guards

20% after deductible

40% after deductible

Major services

Includes prosthodontics; inlays/onlays; crowns and cast restorations

30% after deductible

60% after deductible

Maxillofacial prosthetics

Not covered

Not covered

Orthodontics

Not covered

Not covered

Santa Barbara

The chart below highlights what UC SHIP covers and how much you pay for services. Except for preventive care, you will pay a deductible for services you receive. After you meet the deductible, the plan will pay a portion of the cost. Certain expenses and services are excluded from coverage.

 

Delta Dental PPO Network

Other Delta Dental Networks or Out-of-Network

Annual deductible

Preventive and diagnostic services: $0

Other services: $25 per person/$150 per family

Preventive and diagnostic services: $0

Other services: $25 per person/$150 per family

Annual benefit maximums

$1,200 per member, not to exceed a cumulative maximum of $1,000 each benefit year for network plus out-of-network dental benefits in total

$700 per member, not to exceed a cumulative maximum of $1,000 each benefit year for network plus out-of-network dental benefits in total

Fee schedule

PPO providers agree to accept the Delta Dental PPO maximum allowed fee schedule.

You are responsible for the difference between the amount Delta Dental pays and the amount your out-of-network dentist bills.

 

See note about cost difference below.*

Preventive and diagnostic services

Includes oral exams; cleanings (twice every 12 months); X-rays (one bitewing series within 12 months); fluoride treatment

$0

30%

Basic services

Includes fillings and extractions; composite fillings on back teeth; endodontics (root canals); periodontics; oral surgery; night guards

20% after deductible

50% after deductible

Major services

Includes prosthodontics; inlays/onlays; crowns and cast restorations

50% after deductible

50% after deductible

Maxillofacial prosthetics

Not covered

Not covered

Orthodontics

Not covered

Not covered

*You’ll always pay less when you get care from a Delta Dental PPO network dentist. By comparison, you will usually have the highest out-of-pocket costs when you visit an out-of-network dentist. Note: Although they are out-of-network providers, Delta Dental Premier dentists will apply the approved fee schedule, so you would have lower costs than with other out-of-network dentists.

Costs not covered by Delta Dental

Find complete plan details and a list of dental plan exclusions in the Combined Evidence of Coverage and Disclosure Form. The Evidence of Coverage Form is available in English or in Spanish.