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Know your benefits
Open enrollment period is Sept. 1 - Oct.15
The UFT Welfare Fund provides dental benefits through three types of programs: the Scheduled Benefit Plan, which provides services through our panel or a dentist of your choice; 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 panel dentists (called SIDS), many of the routine procedures such as cleanings are free. Panel dentists may charge a co-pay of $150 for certain high-cost procedures, such as root canals, crowns and dentures, and $200 for orthodontic appliances.
Tips if you see a dentist not on the panel
The Scheduled Benefit Plan allows you to see any dentist, but if you go to a dentist not on the panel, 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 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 both be downloaded at www.uftwf.org, or you can call the Welfare Fund Forms Hotline at 1-212-539-0539.
In Florida, the PPO panel (Cigna) operates in the same manner, with little or no out-of-pocket costs if you use a panel dentist. To reach the dental panelists in the New York area, call 1-866-679-SIDS or 1-516-394-9408, or visit www.uftdental.com. To reach the Florida PPO panel, call 1-800-577-0576 or visit www.uftwf.org or www.mycigna.com.
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, and 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.com].
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.
While enrolled in the Dentcare HMO plan, dental services performed by a non-Dentcare provider are not reimbursable. If you would like specific information about this plan, please contact Dentcare directly at 1-800-468-0608 or 1-516-542-2700.
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. 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.
While you are enrolled in the Florida Dental Discount Plan, dental services performed by a non-Florida Dental Discount Plan provider are not reimbursable. If you would like specific information about this plan, please contact the Florida Dental Discount Plan at 1-888-200-0322 and refer to Plan S200. It is administered by Healthplex America and can be found online at www.yourdentalplan.com/healthplex.
If you are a snowbird or travel a lot, you should stick with the Scheduled Benefit Plan since you will be able to either access the network dentists or submit claims for services provided by a non-network dentist.