Delta Dental Plan Options
for Massachusetts Students

2021-2022 Policy Year


Dear Massachusetts Students,

University Health Plans is pleased to offer students attending colleges and universities in MA and their dependents a choice of two dental insurance plans (DeltaCare and Total Choice PPO). You may enroll in these plans on a VOLUNTARY basis; they are not required insurance. 

If you are a student at a college or university other than in Massachusetts, go back to the home page and type in your school to see if they offer a voluntary dental plan.

As with any insurance plan, please make sure that you have read the Plan Highlights & Benefit Information before enrolling in either dental plan. The copayments on the DeltaCare flyer and the Total Choice flyer are subject to change. The most up-to-date copayment schedule can be found on www.universityhealthplans.com at any time during the policy year.

The premium cost, which includes an admin fee, for each coverage option is as follows:  


DELTACARE PLAN:

Please note: As part of the enrollment process for the "DeltaCare" Dental Plan, you (and any dependents you choose to enroll) must select a "DELTA CARE" General Dentist as your Primary Care Dentist (PCD). If you do not choose a DeltaCare General Dentist as your PCD, Delta Dental will choose one for you that is closest to your area. 

NOTE: The "DELTA CARE" network is a Massachusetts network only. Do NOT Choose "DELTA CARE USA" as your network when searching for a provider. Your enrollment form will not be accepted without this election. Please refer to the participating provider list on the website for a complete, up to date, list of participating providers. TheTotal Choice Plan does not require enrollees to select a primary care dentist.

CHOOSING A PRIMARY CARE DENTIST (PCD): This plan is a Dental HMO plan. You must choose a General Dentist located in Massachusetts who participates in the DeltaCare plan as your PCD. A list of general dentists and their facility ID numbers can be found by clicking "Participating Providers" under the DeltaCare section on the left of this page. When looking for providers, be sure to select "DeltaCare" as your plan. DO NOT SELECT ANY OTHER PLAN on the provider search page. For example, a dentist who accepts Delta Premier may not accept other Delta plans, such as DeltaCare or Delta Dental PPO. This plan is a "DeltaCare" plan. 

The enrollment deadline for coverage effective November 1, 2021 through August 31, 2022 is October 10, 2021. The total cost for coverage is as follows:

  Premium Admin Fee* Total Cost
Student Only: $250.70 $30.30 $281.00
Student & 1 Dependent: $470.20 $60.80 $531.00
Student & 2 or more Dependents: $708.00 $90.00 $798.00

*an administrative fee is included for system processing, platform management and credit card processing.


TOTAL CHOICE PPO PLAN:

Please note: The Total Choice PPO Plan does not require enrollees to select a primary care dentist. The PPO network is a Massachusetts network only.

PARTICIPATING PROVIDERS: This plan utilizes the Massachusetts Total Choice PPO network. You do not need to select a primary care dentist. You will receive the greatest out-of-pocket savings when visiting a Massachusetts Total Choice PPO network provider. Be sure when looking up providers to select "Total Choice PPO " as your plan. Do not assume that because a dentist accepts "Delta Dental" that he/she accepts all Delta Dental plans. This plan is a Total Choice PPO plan. Note: All services outside of Massachusetts are considered out-of-network.

2021-2022 PLAN CHANGE NOTICE: 

  • There will be a $50 individual/$150 family deductible for all in-network Type 2 (Basic Restorative) and Type 3 (Major Restorative) services.
     
  • There will be a 3 month waiting period on Type 2 (Basic Restorative) and Type 3 (Major Restorative) services. Students currently enrolled in the Total Choice Plan who are re-enrolling for the new policy year have already satisfied their 3-month waiting period.
     

The enrollment deadline for coverage effective November 1, 2021 through October 31, 2022 is October 10, 2021. The total cost for coverage is as follows:

  Premium Admin Fee* Total Cost
Student Only: $659.04 $30.96 $690.00
Student & 1 Dependent:   $1,337.28 $60.72 $1,398.00
Student & 2 or more Dependents: $2,008.68 $90.32 $2,099.00

*an administrative fee is included for system processing, platform management and credit card processing.

IMPORTANT: Please review the Plan Highlights & Benefit Information for both dental plans offered to you BEFORE enrolling in either. Refer to the FAQs for an overview of the main differences between the two plans.

Should you have any questions regarding the enrollment process, please contact University Health Plans via email at info@univhealthplans.com or at 800-437-6448.