Insurance options for BU employees
Insurance option 1: Dental Maintenance Organization (DMO)Employees may elect to seek care from either a Boston University Dental Health Center or from any dental office of their choice. Coverage will vary based on where the service is delivered.
If a plan member seeks care from Boston University Dental Health Centers, the coverage is as follows:
Coverage for care received at a BU Dental Health Center:
- basic services (preventive, diagnostic, restorative, i.e., routine fillings): 100%
- major services: (crowns, bridges, root canals, gum treatment): 60%
- orthodontics: 40%
- no deductible
- $1,700 annual maximum benefit per person per calendar year
- coverage based on Boston University Dental Health Center fees, which are approximately 30% to 40% below area private practice fees
- 2005 benefit amounts (pdf)
- no claim form
If a plan member seeks care from an outside office, the dentist must fill out a claim form and send it to Boston University for processing; reimbursement will be sent directly to the patient. No payments will be sent directly to the dental office. There is no assignment of benefits.
Download a claim form for care received at an outside office.
Coverage percentage and comparison:
| BU Dental Health Center | Outside Dentist* | |
| basic services (preventive, diagnostic, restorative, including cleanings twice a year) | 100% | 80% |
| major services (crowns, bridges, root canals, gum treatment) | 60% | 50% |
| orthodontics | 40% | 0% |
| cosmetic services (e.g., bleaching and veneers) | 60% | 0% |
| *Allowance for care outside the centers is based on the fee schedule established by Boston University Dental Health Center. | ||
In brief:
- no deductible
- $1,700 annual maximum benefit per person per calendar year
- no claim forms for services received at BU Dental Health Centers
- Benefits for this option will be paid at a percentage of the BU Dental Health Center's fee schedule. If outside treatment exceeds $300, the dentist must submit a pretreatment estimate for review by plan administrators.
- The plan will reimburse up to 80% of the Boston University Dental Health Centers' standard fee for preventive, diagnostic, and basic services, and up to 50% of the center's standard fee for major services. Note that the centers' standard fees are approximately 40% lower than the average cost of dental services in the Boston area.
- fee schedule (pdf)