University of Oklahoma Health Sciences Center students and dependents may enroll in an optional dental insurance plan that has been tailored to fit their needs. This plan, offered through Ameritas Life Insurance Corp., provides preventive and basic coverage and access to a nationwide Participating Provider Organization (PPO) of approximately 75+ dental provider access points in Oklahoma, with an additional 70,000 access points nationwide.

Good For Your Health and Your Pocketbook
University of Oklahoma Health Sciences Center recognizes that good dental health is important to overall health and is pleased to offer students and their dependents the option to enroll in this dental insurance plan.
Did you know approximately 120 severe medical conditions and illnesses can be detected and treated by a dental examination of the mouth, throat, and neck? With dental benefits, which promote regular visits to the dentist, serious oral health problems can be found early and treated more affordably. A healthy mouth reflects better general health and well-being.
The Ameritas dental insurance plan provides coverage for preventive care, with the added peace of mind that you have coverage for more complicated (and expensive) care.

Eligibility
You must be an active student or dependent of a student enrolled at University of Oklahoma Health Sciences Center Student Health Plan.

Enroll Today!
Just complete the online form Click Here

After completing the online form, please allow seven to fourteen days for the Ameritas’ enrollment systems to update and mail your benefit card before scheduling a dentist appointment. Prior to this time, you may not appear as an insured member of the plan.

Fall Enrollment Deadlines:
College of Medicine III, IV & Physician Assistant 9/14/07
College of Pharmacy 9/14/07
College of Allied Health 9/14/07
College of Dentistry 9/14/07
College of Medicine I & II & Nursing 9/14/07
Public Health & Graduate College 9/14/07

Dental Plan Highlights
Coinsurance (Plan Pays)
Type 1 - Preventive Procedures.............................................................................................100%
Evaluations (Allowed once in a six-month period)
Cleanings (Allowed once in a six-month period)
Full Mouth/Panoramic X-rays (1 in 5 years)
Bitewings (Allowed once in a 12-month period)
Fluoride for Children (Under age 13)

Type 2 - Basic Procedures ......................................................................................................80%
Periapical X-rays
Sealants (Under age 13)
Restorative Amalgams
Restorative Composites
Oral Surgery - Simple Extractions
Denture Repair
Endodontics (Root Canals)

Type 3 - Major Procedures ..........................................................................................Not Covered

Deductible Amounts
Type 1 - Preventive Procedures
Deductible Waived.......................................................................................................................$0

Type 2 - Basic Procedures
Plan Year Per Person/Accumulative ...............................................................................$50 / $150

Maximum
Type 1- Preventive and Type 2 - Basic Procedures
Plan Year Per Person .......................................................................................................$750
The procedures listed above are only a sample of the dental procedures payable under this plan.
A complete list of covered procedures can be found in the certificate of insurance.

Premiums
Annual Rates
Student $182
Spouse/Same-Sex Partner (SSP) Additional $198
One or more children Additional $284
Annual rates are effective for the same dates as your program's individual effective dates.

Refund Policy – except for medical withdrawal due to a covered accident or sickness, any student withdrawing from University of Oklahoma Health Sciences Center during the first 31 days of the period for which coverage is purchased will not be considered covered under the Policy and will receive a full refund of the paid premium. Students withdrawing after 31 days will remain covered under the Policy for the full period for which premium has been billed and no refund will be allowed. Refunds of premiums are allowed only upon entry into the armed forces.  No other refunds will be allowed.

Participating Provider Organization (PPO)
The University of Oklahoma Health Sciences Center student dental plan includes a PPO network option. The Ameritas PPO is a group of dentists who agree to provide dental services at discounted fees to individuals who are covered under Ameritas’ dental insurance plans. Plan benefits are the same whether you visit an Ameritas PPO dentist or a non-PPO dentist. But if you do visit an Ameritas PPO dentist, the amount you pay for a procedure will almost always be lower. Visiting an Ameritas PPO dentist can result in savings of 10-30 percent. If you visit a non-PPO dentist, the dental procedure charges are reimbursed up to the PPO discounted fee amount in the ZIP code area where the dental work was received. If the non-PPO dentist charges are above the PPO discounted fee, the member is responsible for any remaining dollar amount.

To find a PPO provider in your area, please visit Ameritas Group
Download an Ameritas Claim Form or contact the Ameritas claims department at toll free 800-487-5553

Plan Limitations and Exclusions
Covered Expenses will not include and no benefits will be payable for expenses incurred:

• for any procedure except exams, cleaning and fluoride applications for the first 24 months when a student or dependent becomes classified as a late entrant. If a student or dependent does not enroll within 31 days from the date the person qualifies for the insurance or who elected to become covered again after canceling a premium contribution agreement will be classified as a late entrant.
• for any treatment which is for cosmetic purposes. Facings on crowns or pontics behind the second bicuspid are considered cosmetic.
  
• to replace any prosthetic appliance, crown, inlay or onlay restoration, or fixed partial denture within ten years of the date of the last placement of these items. However, if a replacement is required because of an accidental bodily injury sustained while the person is covered, it will be a Covered Expense.
• for initial placement of any prosthetic appliance or fixed partial denture unless such placement is needed because of the extraction of one or more teeth while the plan member is covered under the dental expense benefit. The extraction of a third molar (wisdom tooth) will not qualify under the above. Any such appliance or fixed partial denture must include the replacement of the extracted tooth or teeth.
• for any procedure begun before the plan member was covered under the dental expense benefit.
• for any procedure begun after the member's insurance under the dental expense benefit terminates; or for any prosthetic dental appliances installed or delivered more than 90 days after the member's insurance under the dental expense benefit terminates.
• to replace lost or stolen appliances.
• for appliances, restorations, or procedures to:
  alter vertical dimension;
  restore or maintain occlusion;
  splint or replace tooth structure lost because of abrasion or attrition
  for any procedure which is not shown on the Table of Dental Procedures.
  for orthodontic treatment. (Unless otherwise specified in this contract.)
• for which the plan member is entitled to benefits under any workmen's compensation or similar law, or charges for services or supplies received as a result of any dental condition caused or contributed to by an injury or sickness arising out of or in the course of any employment for wage or profit.
• for charges for which the plan member is not liable or which would not have been made had no insurance been in force.
• for services which are not required for necessary care and treatment or are not within the generally accepted parameters of care.
• because of war or any act of war, declared or not.