Tips
for getting the most from your UFT dental coverage
Nov 16, 2006 12:27 PM
The UFT Welfare Fund provides dental benefits through three types of
programs: the Scheduled Benefit Plan, which offers more choices but can
entail out-of-pocket expenses; Dentcare, a no-cost dental HMO; and the
Florida Dental Discount Plan for year-round Florida residents.
The plan that you are automatically enrolled in as a new UFT member is
the Scheduled Benefit Plan. If you select one of the UFT’s 600 or so
panel dentists (called SIDS), your annual check-up and cleaning plus
routine procedures such as fillings are free. Panel dentists may charge
a co-pay of $50 for certain high-cost procedures, such as root canals,
crowns and dentures, and $100 for orthodontic appliances.
Tips if you see a non-panel dentist
The Scheduled Benefit Plan allows you to see any dentist, but if you go
to a non-panel dentist, your out-of-pocket costs can grow. You are
responsible for the difference between your dentist’s charges and the
plan’s reimbursements. It’s a good idea to show your non-panel dentist
a copy of the UFT’s “Schedule of Covered Dental Expenses” since it
might influence how much he or she charges you.
The dental forms and the fee schedule can be downloaded at
www.uft.org/member/benefits/forms or you can call the Forms Hotline at
1-212-539-0539.
The no-cost option
Enrollment in Dentcare allows you to avoid all out-of-pocket dental
expenses. Just as with a health care HMO, you select a primary dentist
from Dentcare’s list of more than 350 providers in the tri-state area.
That dentist will perform all necessary work or will refer you to a
Dentcare specialist if deemed necessary. There are no co-pays, no
claims to file, no danger of hidden costs for covered services.
A few factors for you to consider: If you have a dental emergency while
traveling, Dentcare will only reimburse you up to $50 for pain relief.
You have to return home for any dental work. If you have young
children, be aware that Dentcare does not offer pediatric dentists.
If you’d like to continue seeing your current dentist, you should check
to see if your dentist participates in Dentcare (go to
www.healthplex.com and click on Find a Dentist) or is a SIDS dentist
(go to www.uftdental.org). If your dentist happens to belong to both
plans, you will save money by enrolling in Dentcare, though keep in
mind that if you need serious dental work, you will need a referral to
see a specialist on the Dentcare panel. If your dentist belongs to
neither plan, you’ll need to decide whether continuing to see that
dentist is worth the extra out-of-pocket expense.
A third option for Florida retirees
Florida retirees have a third option: the UFT Florida Dental Discount
Plan.
This discount plan is geared to year-round Florida residents who do not
live on the state’s southeast coast. Just as in Dentcare, you pick a
dentist from the discount plan’s list. There is no paperwork and no
charge for routine and preventative care. You will have a discounted
fee (see the schedule) for more complicated procedures, but it will
almost always cost you less than what you would have to pay if you went
to a non-panel dentist and were reimbursed through the Scheduled
Benefits Plan.
If you are a retiree living on Florida’s southeast coast, you should
stick with the Scheduled Benefit Plan since there are panel dentists in
your area and the co-pays in that plan are lower.
If you are a snowbird, you should also stick with the Scheduled Benefit
Plan since neither Dentcare nor the Florida Dental Discount Plan has
networks of dentists in both states.
The open enrollment period for changing dental plans is Sept. 1 through
Oct. 15 each year.