Dental Coverage Frequently Asked Questions (FAQs)
Please use the following FAQs to assist you with your dental benefit questions. For additional questions about specific coverage, claims, or costs, please contact Aetna at 877-238-6200 or Delta Dental at 800-524-0149. For questions about plan eligibility, please contact the MSU HR Solutions Center at 517-353-4434, 800-353-4434 or SolutionsCenter@hr.msu.edu.
Dependents
Adding a dependent requires you to complete an Add Family Member or Dependent Form in the EBS Portal for each dependent you would like to add to your benefit plans. You will also be required to supply additional documentation such as a marriage certificate, birth certificate(s) and/or court documents for each dependent you are adding.
Additional Documents can be:
- Emailed to SolutionsCenter@hr.msu.edu,
- Faxed to 517-432-3862,
- Mailed or brought to the Human Resources offices at 1407 S. Harrison Road, Suite 110, East Lansing, MI 48823-5239
Requests, to add new dependents to your plan(s), and documentation must be received within 30 days of being hired, becoming newly eligible, or if you have a mid-year qualifying event. Suppose you do not enroll your dependent(s) within the allotted time. In that case. you must postpone enrollment until the next open enrollment period, in October, unless you have a qualifying life event.
For more information about enrolling your dependents, please see Benefits Enrollment/Changes.
You may only add a spouse or dependent to your benefits, outside of the Open Enrollment period, if you experience a qualifying life event, which includes marriage, childbirth/adoption, loss of existing coverage for you and your family members, or retirement. Changes must be made within 30 days of the qualifying event. Learn more on the Life Event Changes webpage.
Eligibility
Eligible dependents include legal spouse/Other Eligible Individual (OEI), eligible children (biological, legally adopted, or step), grandchildren (non-adopted), nieces (non-adopted), nephews (non-adopted) and wards under legal guardianship (foster children through age 18).
Note: Dependent children may be covered for dental until the end of the calendar year when they reach age 23. For more information about dependent eligibility and required documentation, please see Eligible Dependents and Required Documentation.
Aetna DMO and Aetna DMO Premium offer orthodontic benefits to children and adults. Please see the Aetna DMO or Aetna DMO Premium brochures for co-pay amounts.
Delta Dental PPO pays a lifetime maximum of $600 for orthodontic benefits for you and each of your eligible dependents, provided you or your eligible dependent is under age 19. Please review the Delta Dental PPO brochure for more information.
Delta Dental PPO Premium pays a lifetime maximum of $2,000 for orthodontic benefits for you and each of your eligible dependents. Please review the Delta Dental PPO Premium brochure for more information.
Claims
Aetna DMO & Aetna DMO Premium - Aetna is a Dental Maintenance Organization (DMO), which means you must select a Primary Care Dentist (PCD) in their provider network. Since you must select an in-network provider, no claim forms would need to be submitted since they will submit the claim for you.
Delta Dental PPO & Delta Dental PPO Premium - In-network dentists will submit your claim for you. If you choose an out-of-network dentist, you or your dentist should send your claims to the address indicated on your Member ID card. You may obtain a claim form from your member portal on the Delta Dental website. Follow the instructions on the form to process the claim.
Aetna: 877-238-6200
Delta Dental: 800-524-0149
Other
No. You must wait until October's next Open Enrollment period to change dental plans.
Note: Please see the FAQ below about moving out of a service area.
Aetna: Once enrolled for your dental benefits, please visit the Aetna website to find a participating Primary Care Dentist (PCD) along with finding your member ID information. You must choose a primary care dentist before an ID card will be mailed to you. Please contact Aetna at 877-238-6200 with any questions.
Delta Dental: Once enrolled for your dental benefits, you will receive ID cards from Delta Dental. You may also find your member ID information when you login/register to the Delta Dental Member Portal. If you are still waiting to receive ID cards from Delta Dental or have any questions regarding your ID cards, contact Delta Dental directly at 800-524-0149.