DENTAL INSURANCE COVERAGE

Dental Insurance Plan Brochure

WAITING PERIOD: The Waiting Period is the period of time following the insured person's effective date of coverage during which no benefits are payable for covered dental charges. There is a Waiting Period of six (6) months for most Basic Services (see Usual and Customary Benefits).
Note: please contact Student Health at 415-476-1281 for more information on the waiting period!

ELIGIBILITY: All eligible students are covered. An eligible student is one who is registered and has paid the health fee.

DEDUCTIBLE AMOUNT: The Deductible is an amount of covered dental charges incurred by an insured person for which no benefits will be paid. The Deductible amount will apply to each insured person.

CALENDAR YEAR MAXIMUM: The Calendar Year Maximum is the maximum amount payable for all Eligible Dental Expenses in any calendar year. The Calendar Year Maximum will apply to each insured person.

USUAL AND CUSTOMARY: A Usual and Customary charge is a charge that does not exceed the 80th percentile of the Ingenix table of Usual and Customary charges for providers of dental services in the area where the charge is incurred.

ELIGIBLE EXPENSES: Eligible Expenses must be incurred while the Policy is in force and the person is covered by the Policy. To be an Eligible Expense, the dental service must be performed by: 1) a licensed Dentist acting within the scope of his or her license; 2) a licensed Physician performing dental services within the scope of his or her license; or 3) a licensed dental hygienist acting under the supervision and direction of a Dentist.