Dental Benefits - Human Resources at Ohio State
All of the benefits available to you reflect Ohio State’s commitment to providing high-quality, affordable plans and represent a significant component of your total rewards for working at Ohio State.
The Dental Plan provides coverage for many dental services that you and your eligible dependents may need. The plan offers both network and out-of-network coverage.
You have two coverage options. The Dental Plus benefit option has higher employee payroll contributions than Dental Basic and it provides a greater level of benefit coverage, including a lower deductible, higher annual benefit maximum and a higher lifetime orthodontia maximum with no age limit.
Delta Dental of Ohio provides national network coverage through two networks: Delta Dental PPO and Delta Premier. You receive greater benefit coverage when you use a provider who participates in the Delta Dental PPO network.
- Faculty and Staff Dental Plan Specific Plan Details Document
- Summary of Material Modifications issued 4/21/2022 (Benefits coverage changes related to COVID-19)
Dental Benefits Information
Effective Jan. 1 – Dec. 31, 2022
|Covered Services||DENTAL BASIC||DENTAL PLUS|
|Delta Dental PPO Network (includes OSU Student Dental Clinic)||Delta Dental Premier Network||Out-of-Network||Delta Dental PPO Network (includes OSU Student Dental Clinic)||Delta Dental Premier Network||Out-of-Network|
|Annual Deductible||$0||$50 per person||$100 per person||$0||$25 per person||$50 per person|
|Annual Maximum Benefit||$1,500 per person 1,3||$1,200 per person 1,3||$2,500 per person 1,3||$2,000 per person 1,3|
|Preventive Services (includes: cleanings, sealants, fluoride treatments, and space maintainers; bitewing, full-mouth or panoramic X-rays), Emergency Palliative Treatments and Oral Examinations||100% of allowed amount; no deductible; no balance billing 2||100% of allowed amount; no deductible; subject to balance billing||100% of allowed amount; no deductible; no balance billing 2||100% of allowed amount; no deductible; subject to balance billing|
|Endodontics (root canals), Oral Surgery (includes impacted tooth extraction), Periodontics (gum disease), Restorative Services – Minor (includes fillings, and repair of bridgework crowns, dentures, and onlays) and X-rays, All Others (includes all diagnostic)||80% of allowed amount, no deductible; no balance billing 2||75% of allowed amount; after deductible; no balance billing 2||70% of allowed amount; after deductible; subject to balance billing||80% of allowed amount, no deductible; no balance billing 2||75% of allowed amount; after deductible; no balance billing 2||70% of allowed amount; after deductible; subject to balance billing|
|Orthodontics||100% of allowed amount, up to $1,200 lifetime maximum;1 no deductible||50% of allowed amount, up to $1,200 lifetime maximum;1 no deductible||100% of allowed amount, up to $2,000 lifetime maximum;1 no deductible||50% of allowed amount, up to $2,000 lifetime maximum;1 no deductible|
|Coverage is only available for children up to age 19. Benefits are pro-rated and paid over the course of the treatment.||Coverage is available for children and adults with no age limit. Benefits are pro-rated and paid over the course of the treatment.|
|Prosthodontics (includes dentures, fixed bridgework, and implants) and Restorative Services – Major (includes cast restorations and crowns)||55% of allowed amount, no deductible; no balance billing 2||50% of allowed amount; after deductible; no balance billing 2||50% of allowed amount, after deductible; subject to balance billing||55% of allowed amount, no deductible; no balance billing 2||50% of allowed amount; after deductible; no balance billing 2||50% of allowed amount, after deductible; subject to balance billing|
|Temporomandibular Disorder (TMD)||No coverage under Dental. Limited coverage is available under Ohio State’s medical benefits.|
|1 You are responsible for all costs over the maximums.
2 For any optional treatment (defined as a service that is more expensive than what is customarily provided or for which Delta Dental does not determine that a valid dental need is shown), you are responsible for the costs over the allowed amount, regardless of whether or not the service is provided in-network.
3 Some services are excluded from the annual maximum. A list of these services can be found in the Faculty and Staff Dental Plan – Specific Plan Details Document.
NOTE: This Dental Summary Chart should be used as a general guide only. Refer to the Faculty and Staff Dental Plan Specific Plan Details Document for further information. If the information in the summary chart differs from the Specific Plan Details Document, the Specific Plan Details Document will govern.
If you use a network provider:
- Tell the provider’s office that you are covered by Delta Dental when making an appointment, or at the time of service.
- No claim forms are necessary for network dental services. Your dental provider should file claims directly with Delta Dental, although you may be required to pay for your portion of the expenses at the time of service.
If you use an out-of-network provider
- The plan pays less for covered services than it does when you use a network provider.
- Your provider may require you to pay for services in full and be reimbursed from Delta Dental by filing a claim.
To help protect themselves and their patients, dentists and staff are wearing more personal protection equipment (PPE) during appointments. This includes masks, face shields, gowns and gloves. The cost of these items has increased with demand, and as a result, some dentists are asking their patients to pay a separate charge for PPE.
However, Delta Dental participating dentists cannot charge you separately for PPE. Per their participation agreement, the cost of PPE is included in the cost of the dental service.
Protecting you from additional charges and fees is just one advantage of staying in network. If your dentist is out-of-network and they charge you for PPE, you are responsible for that cost.
What do I do if my dental office says I have to pay a PPE charge?
If they are in the Delta Dental network, remind them that they cannot charge you separately for PPE.
What if I already paid a PPE charge to my dentist?
If your dentist is in-network and billed you for the cost of PPE, you can submit a balance billing complaint to Delta Dental for follow up. Complaints should include the member name and phone number, date of treatment, dental office name and phone number, and the fee charge. Send complaints to Delta Dental, Attention: Balance Billing, PO Box 9230, Farmington Hills, MI 48333-9230.
What are you doing to help dental offices with the increased cost of PPE?
We understand the financial hardship the pandemic has placed on dentists and practices. That’s why we are offering any practicing, licensed dentist in Michigan, Ohio and Indiana a $1,000 credit to a dental supply distributor. This credit may be used to purchase PPE. Learn more about the provider relief credit by visiting deltadentaloh.com/dentistrelief.
Many Ohio State-based dental providers are included in Delta Dental’s networks.
- The Ohio State University Student Dental Clinic is in the Delta Dental PPO network.
- Some, but not all, of the providers within the Ohio State Dental Faculty Practice are in the Delta Dental PPO or Delta Premier network.
Upon your request, Delta Dental will determine benefit coverage prior to you receiving dental service(s) if the course of treatment is expected to be $200 or more. You or your dentist can send a written description of the procedures and the dentist’s proposed charges to Delta Dental before treatment begins.
The Delta Dental Mobile App helps you get the most out of your dental benefits anytime, anywhere. Use the dentist search or toothbrush timer without logging in, or enter your username and password to securely access your personal benefit information or estimate your dental care costs. Delta Dental’s free app is optimized for iOS (Apple) and Android devices. To download our app on your device, visit the App Store (Apple) or Google Play (Android) and search for Delta Dental. Delta Dental Mobile App information
Dental Plan FAQ
Delta Dental provides network coverage through Delta Dental PPO and Delta Dental Premier. The OSU Student Dental Clinic is in the Delta Dental PPO network. You can find network dentists online through the Delta Dental website.
The OSU Employee ID is to be utilized for this purpose since it is a number with which you should already be familiar. Delta Dental’s system requires a 9-digit identification number for eligibility and claims processing; therefore, if you have a:
- 8-digit OSU Employee ID – your Delta Dental ID is your Employee ID with a leading zero added to it.
- 9-digit OSU Employee ID – your Delta Dental ID is your Employee ID with no changes.
Each enrolled member and their dependents may have two regular cleanings and exams in the plan year. Two additional cleanings will be covered when medically necessary. (Two additional cleanings per benefit year are considered medically necessary for individuals with at-risk conditions such as documented periodontal disease, diabetes, kidney failure, organ or bone marrow transplant recipient, and for individuals receiving dialysis, chemotherapy, radiation treatment, or are HIV positive.)
This is intended to be an overview. Refer to the Plan Document for complete information. In the event the information on these pages differs from the Plan Document, the Plan Document will govern.