Graduate Assistant Health Benefit Plan

Graduate assistant coverage

2. Dependent coverage

• A dental exam at six and twelve month intervals
• An adult prophylaxis (routine teeth cleaning) at six and twelve month intervals
• Four bitewing radiographs one additional radiograph per year
• a panorex once every five years if needed, only at the time of the dental exam

Emergency care is available to alleviate pain and/or discomfort. During normal clinic hours call the Dental Clinic phone number (612-624-9998).

After normal clinic hours, during evenings and weekends calling this same number will provide contact information for emergency care.

If you choose to have your preventative dental work performed outside of Boynton Dental Clinic, a one-time credit (per academic year) of up to $150.00 will be refunded to you by check. You must provide a copy of your bill within 45 days of the appointment clearly indicating your name and the treatment received from the provider.

• To request for this reimbursement, fill out the Dental Reimbursement Form* and follow instructions on the form on how to submit.
   
• Example: If you have your teeth cleaned at Dr. Smith’s office, you receive and pay the bill for the covered preventive services. You provide us with a copy of your bill and we will issue reimbursement for up to $150.00
  
  
• Electing this reimbursement option means that you may not receive free preventive treatment during the plan year (September 1, 2008-August 31, 2009).
  Important: Restorative treatment obtained outside of Boynton Dental Clinic is not covered by the Plan and not eligible for reimbursement.

If you have any problems making an appointment within 5 weeks, please contact the Boynton Health Service Dental Clinic by one of the above methods.

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Your dependents will receive preventive and other covered restorative dental services at a discount of 20-30% below the regular fee schedule, when treatment is paid for at the time of service. The discount does not apply to patients who already have other dental insurance coverage. Your dependents can be treated even if you have not enrolled them in the GA medical plan. They should always use your student ID number when making appointments to assure them of their discounts.

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When calling for an appointment

1. Please have your student ID# ready when you make your initial call. This where your chart will be made, where your hygiene and exam appointments will take place, and where most of the covered discounted services will be provided.
    
2. Please identify yourself as a Graduate Assistant when you make your appointments to to ensure that your hygiene appointments, exams and bitewing radiographs that are allowed under the Plan, are performed for you at no cost. Boynton Dental is also the primary clinic where your dependents will be seen.
   
3. This is also the primary clinic where your dependents will be seen. Your dependents can be treated even if you have not enrolled them in the medical plan. They should always use your ID number when making appointments to assure them of their discounts.
   
   Please be aware that this is not a walk-in clinic. Always call to schedule your appointments as it will help us to provide you with the best possible care.

Optional Referrals

To facilitate your dental treatment, you may be referred to another clinic located within the School of Dentistry in Moos Tower for the few specialty services not provided in our clinic. Services received outside of Boynton are not covered by the plan.

Payment

Coinsurance for a student’s restorative care and restorative and preventive services for dependents will be charged at the completion of treatment. Payment is expected at the time of service. You may request that services be charged to your student account. If payment is not made at the time of service, your SAR account will automatically be charged the appropriate amounts.

Honoring Appointments

Please note that the Graduate Assistant Dental Plan adheres to the Boynton Health Service Dental Clinic failure/late arrival policy for dental appointments. Cancellation within 24 hours of an appointment constitutes a failed appointment.

• Arrival 10 minutes after the appointed time constitutes a failure and you will have to be rescheduled.
  
• Cancellation within 24 hours of an appointment constitutes a failed appointment.
  
• Two failures within a two year period will result in refusal on the part of the clinic to make further appointments.

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