MSU Human Resources >> Benefits >> Dental >> Dental Coverage FAQs


Dental Coverage 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 +1 (877)-238-6200 or Delta Dental at +1 (800)-524-0149. For questions about plan eligibility, please contact the HR Solutions Center at SolutionsCenter@hr.msu.edu or (517)-353-4434.

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 marriage certificates, 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 plans 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, adopted, or step), grandchildren (non-adopted), nieces (non-adopted), nephews (non-adopted), 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 Premium DMO offer orthodontic benefits to children and adults. Please see the  Aetna DMO  or  Aetna Premium brochures for copay 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 Premium PPO pays a lifetime maximum of $2,000 for orthodontic benefits for you and each of your eligible dependents. Please review the Delta Dental Premium PPO brochure for more information.

Claims

Aetna DMO and Aetna Premium DMO - Aetna is a dental maintenance organization (DMO), which means you must select a primary care dentist 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 or Delta Dental Premium PPO - 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: +1 (877)-238-6200

Delta Dental: +1 (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.

If you are covered under Aetna, you may change to Delta Dental PPO or Delta Dental Premium PPO when moving out of the service area.
Under the Consolidated Omnibus Budget Reconciliation Act of 1986 ( COBRA ), if an employee and/or their eligible dependents involuntarily lose health and/or dental coverage through MSU (i.e., termination of employment, death of employee or retiree, dependent marriage, termination of the OEI relationship, divorce/separation, etc.), notification of  COBRA   r ights will be sent by MSU Human Resources. A completed election form must be returned to MSU Human Resources within 60 days from the date of notification or loss of coverage, whichever is later.

Aetna : Once enrolled for your dental benefits, please visit the Aetna website to find a participating primary care dentist. You must choose a primary care dentist before an ID card will be mailed to you. You may also find your member ID information when you login/register to the Aetna membership account. Please contact Aetna at +1 (877)-238-6200 with any questions.

Delta Dental : Once you enroll for 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 membership portal. If you are still waiting to receive ID cards from Delta Dental or have any questions regarding your ID cards, contact Delta Dental at +1 (800)-524-0149.

 

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