Know your benefits

Dental care

Sep 17, 2009 4:22 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 700 or so panel dentists (called SIDS), you can have an examination every six months and cleaning every three months at no charge. Routine procedures such as fillings are also 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 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 be downloaded online 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.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.

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 nonpanel dentist and were reimbursed through the Scheduled Benefits Plan.

While 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 1-800-342-5209, reference group number 24039.

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.