DENTAL OPTIONS
STUDENTS
PARENTS
DENTAL OPTIONS
You can do it all
and have a GREAT SMILE

 

You can do it all and have a GREAT SMILE


Dental problems can often lead to time taken away from your already busy schedule. With the RIT Student Dental Plan, you’ll have access to hundreds of local dentists at convenient locations. So you can spend less time worrying about cavities and tooth pain, and more time focusing on your future.

The RIT Student Dental Plan offers convenient dental care for busy undergraduate and graduate students. The plan offers two options depending on your desired level of coverage. With access to our full network of dental providers, you can get the most convenient care – whether you’re living on or off campus, have a co-op in another town or part-time job.

The RIT Student Dental Plan offers convenient dental care for busy undergraduate and graduate students. The plan offers two options depending on your desired level of coverage. With access to our full network of dental providers, you can get the most convenient care – whether you’re living on or off campus, have a co-op in another town or part-time job.

STUDENTS: To enroll...

2. Return the form to:

Attn: Membership and Billing
Excellus BlueCross BlueShield
P.O. Box 21146
Eagan, MN 55121-0146
-or-
Email form to: Karin.Kroth@excellus.com

Do not send premium payment with your enrollment form. You will be billed.
For questions or more information, please contact Customer Service: 1-800-724-1675, TTY 1-800-421-1220, 8:00 a.m. – 5:30 p.m. (Mon. – Th.), 9:00 a.m. – 5:30 p.m. (Fri.)

DENTAL BLUE OPTIONS

OPTION A

In/Out of Network Coverage

OPTION B

In/Out of Network Coverage

Preventive/ Diagnostic

80%/80%

100%/100%

Examinations, cleanings (prophylaxis), bitewing x-rays, full-mouth panorex x-rays, fluoride treatments*, space maintainers*, sealants* (*Age restrictions may apply.)
Basic Restorative

50%/50%

80%/80%

Amalgam fillings, composite fillings, routine/simple extractions

Basic Restorative (Enhanced)

0%/0%

80%/80%

Oral surgery including impacted wisdom teeth removal, anesthesia/IV sedation, root canal treatment, periodontal surgery, periodontal scaling and root planing, periodontal maintenance following surgery
Major Restorative

0%/0%

60%/60%

Inlays/onlays/crowns, fixed prosthetics: bridgework, abutments, pontics, removable prosthetics: partial dentures, complete dentures, denture: relines, rebases, repairs, implants
Orthodontia (Braces)

0%/0%

50%/50%/$1000 MAX

ANNUAL MAXIMUM

$500

$1,000

Annual Cost

OPTION A

OPTION B

Single

$276.24

$642.12

Student/Spouse

$455.04

$1,057.92

Student/Children

$438.36

$1,019.76

Family

$616.92

$1,435.56

Plan coverage 9/01/23 through 8/31/2024. Fall enrollment 9/1/23-10/15/23. Spring enrollment 1/1/24-2/15/24. .