Dental Plan

The University of Michigan dental plan, administered by Delta Dental of Michigan, is designed to promote regular dental visits and good oral health, a key part of your overall wellness.

Three Plan Options

When you enroll, you will choose one of three dental plan options.

  • Option 1 provides the least coverage. For most faculty, staff, and retirees, the university pays the full premium. You pay for any services that are not covered under Option 1.
  • Option 2 provides more coverage with a moderate employee contribution.
  • Option 3 provides the greatest coverage with the highest employee contribution and the lowest out-of-pocket costs.

View a two-minute video for a quick guide to your three options.

Covered Diagnostic and Preventive Services

All three options cover diagnostic and preventive services, including:

  • Oral exams twice per calendar year
  • Cleanings twice per calendar year
  • Emergency treatment to temporarily relieve pain
  • Bitewing X-rays once per calendar year and full mouth X-rays once in any five-year period
  • Non-surgical services to treat gum disease

Option 1 Details

Option 1 is for those who primarily need preventive dental work including regular checkups and cleanings. Delta Dental covers 100% of diagnostic and preventive services, with no deductible. Option 1 does not cover basic services such as fillings, root canals, or oral surgery for the treatment of gum disease. It does not cover major services including crowns, bridges, implants, dentures, or repair of crowns, bridges, and dentures. However, members will pay a discounted rate for these services when they use a PPO or Premier dentist.  If you or your dependents need more extensive dental care, you may wish to consider Option 2 or Option 3.

For most faculty, staff, and retirees, the university pays the full cost for coverage for you and your eligible dependents enrolled in Option 1.

Option 2 Details

Option 2 covers everything Option 1 covers, plus basic services including fillings and root canals at 100% with a PPO dentist and 60% with a Premier dentist. Major services, such as crowns, implants and dentures, are covered at 50% with a PPO dentist and 40% with a Premier dentist.  You and the university share the cost of Option 2. There is a $50 annual deductible per person and a maximum annual deductible of $150 per family per benefit year. The deductible does not apply to diagnostic and preventive services, emergency treatment to relieve pain, x-rays, sealants, periodontal maintenance, sealing and root planning, occlusal guards, and orthodontics.

Option 3 Details

Option 3 provides the greatest coverage and has the highest premium. Coverage is 100% for any dentist for diagnostic, preventive, and basic services, and 50% for major services. You and the university share the cost of Option 3. There is a $50 annual deductible per person and a maximum annual deductible of $150 per family. The deductible does not apply to diagnostic and preventive services, emergency treatment to relieve pain, x-rays, sealants, periodontal maintenance, sealing and root planning, occlusal guards, and orthodontics.

View a comparison chart of the three Dental Plan options.

Choosing a Dentist

You can go to any dentist, but your out-of-pocket costs will vary depending on the level of the dentist’s participation with Delta Dental. Your lowest out-of-pocket costs with be with a Delta Dental PPO dentist. A Delta Dental Premier dentist participates with Delta Dental but your out-of-pocket costs will be higher. If you visit a nonparticipating dentist, you will be responsible for any charges above Delta Dental’s fee schedule, in addition to any copay or deductible.

Learn more about finding and selecting a dentist.

Exclusions and Limitations

Not every dental service is covered. Refer to the Delta Dental PPO Dental Care Certificate for a detailed description of the U-M dental plan and a list of exclusions and limitations for each option.

Preauthorization

Whenever you have a question about whether a dental procedure will be covered, you and/or your dentist should contact your dental plan before you begin treatment. Your dentist should contact Delta Dental and request a preauthorization of covered benefits anytime your dental work is expected to exceed $200.

Contact Delta Dental prior to receiving treatment if you have any questions about what your plan will cover.

Eligibility

See Eligibility and Enrollment for more information on your eligibility for the U-M Dental Plan.

Covered dependent children may remain on your dental plan until the end of the month in which they turn 26. The U-M dental plan covers orthodontic services for eligible dependents up to age 19 at 50% under all three options.

As a retiree, dependents enrolled under your U-M dental plan at the time of your retirement continue coverage as long as they remain eligible. You cannot add new dependents to your benefits as a retiree.

How and When to Enroll

Enroll online through Self Service > Benefits on Wolverine Access. There are three times when you may enroll or make changes:

No ID Cards Needed

No matter which option you choose, Delta Dental does not issue ID cards when you enroll and you do not need a card to receive services. When you make an appointment, the dental office will ask you for your UMID or your Social Security number to verify your enrollment and coverage with Delta Dental. If you still want an ID card, you can print a customized ID card on demand using Delta Dental’s Consumer Toolkit.

Coordinating Coverage When Delta Dental is the Secondary Payer

Delta Dental bases payment on the amount they approve using the maximum approved fee or PPO dentist schedule according to the dentist’s participating status . Delta will pay the balance of that amount after the primary payment or the amount they would pay as primary, whichever is less. The two programs together will not pay more than 100% of covered expenses . A Delta participating dentist cannot balance bill the patient for any difference between the amount charged and the amount Delta approves.

Forms and Documents

Contact Delta Dental

(800) 524-0149
Website: deltadentalmi.com
Online Tools: Member Portal

Mail claim forms to:

Delta Dental
P.O. Box 9085
Farmington Hills, MI
48333-9085