DENTAL BLUE PREVENTIVE This plan only provides coverage for diagnostic and preventive care, such as routine cleanings. If you need other care, such as fillings and root canals, you’ll be responsible for paying the full cost of those services.	DENTAL BLUE COMPREHENSIVE This is a good option if you want the most dental protection. In addition to diagnostic and preventive care, you’ll receive additional coverage for basic and major services, such as fillings, crowns, and root canals.
$	$$
Key Features Pays 100% of diagnostic and preventive care with participating dentists No deductible $500 plan year benefit maximum Access to full Dental Blue dentist network	Key Features Pays 100% of diagnostic and preventive care, 60% of basic services, and 40% of major services with participating dentists $50 deductible/individual plan; $150 deductible/family plan (Basic and Major services only) $1,500 plan year benefit maximum Access to full Dental Blue dentist network
Please review the Dental Plan Comparison Guide for detailed information about each plan’s benefits to make an informed decision.

Effective Dates of Coverage and Enrollment Period
Coverage Period	Open Enrollment Period*
Fall Term: August 1 - July 31	July 1 - September 30
Spring Term: February 1 - July 31 Spring Term enrollment is for new students or those returning from a leave of absence.	January 1 - February 28
*Applications received after the deadline(s) will only be granted with either a life-changing event or confirmation that an online application was submitted prior to the deadline or during the next open enrollment period. ​

Eligibility

• Harvard students and their dependents (student must be participating in the dental plan)
• Extension School students and their dependents (student must be participating in the dental plan when adding dependents. Please contact the Extension School to enroll)
• Affiliates are not eligible to participate in this dental plan

Dependent Eligibility

Dependents can be added during open enrollment or with a life changing event when the student is enrolled. There is an additional fee to add dependents. Enrollment and/or renewal are not automatic (for students or their dependents).

Documentation is required for each family member enrolled in the dental plan.

• Married spouse
• Dependent children (under the age of 26)
  The Student Health Insurance Plan (BCBSMA) includes a dental benefit for members under the age of 19. Compare the Student Health Insurance Plan Summary to this optional Dental Blue plan to make an informed decision about enrolling.

enrollment process

• Extension students MUST submit their applications to the Extension School.
   
• Students enrolling in an individual dental plan should complete the dental application online.
   
• Students Enrolling Dependents:

Please be aware that if you are enrolling children under the age of 19 on your medical plan, children enrolled in the Student Health Insurance Plan have Pediatric Essential Benefits until they reach 19.  To learn about the essential benefits view: https://hushp.harvard.edu/sites/default/files/BCBS_SHIP_Dental_ScheduleOfBenefits.pdf 

If your dependents were previously/currently enrolled in the student health insurance medical plan, you will be able to complete the online enrollment application to add them to your dental coverage.  

If your dependents have not been enrolled in the Student Health Insurance Plan, but you plan to enroll them for Fall 2022: 

1. Complete the medical enrollment application online first 
2. Once the medical application is submitted, you can complete their dental plan enrollment online.  

If your dependents have never been enrolled in the Student Health Insurance Plan, and you DO NOT plan to enroll them for Fall 2022: 

1. Download the paper enrollment application to enroll yourself and your dependents. Do not submit an online application.

NOTE: 

• All family members must be enrolled in the same plan type (preventive or comprehensive) 

• The cost of the plan is applied to your student account

• Only new members will receive ID cards

• Review the cancellation policy prior to enrolling

rates

Charges are applied to your student bill for the full amount. The charges may not appear on your student bill for several weeks after the start of coverage. Purchasing coverage monthly is not available.

Rates for Fall Term enrollment: August 1 - July 31

Contract	Preventive Plan	Comprehensive Plan
Student only	$290	$528
Student + 1 dependent	$560	$1,019
Student + 2 or more dependents	$865	$1,573

 

Rates for Spring Term* enrollment: February 1 - July 31

Contract	Preventive Plan	Comprehensive Plan
Student only	$145	$264
Student + 1 dependent	$280	$510
Student + 2 or more dependents	$433	$787

*Spring Term enrollment is for new students or those returning from a leave of absence.

Benefits and Coverage

Choose the dental plan that is right for you by reviewing the summary chart below:

	Preventive Plan	Comprehensive Plan
Plan Year Maximum	$500	$1,500
Diagnostic Type 1 Benefits	100% coverage	100% coverage
Preventive Type 1 Benefits	100% coverage	100% coverage
Basic Type 2 Benefits		60% after deductible
Major Type 3 Benefits		40% after deductible

Review the Dental Plan Comparison Guide for detailed information about each plan’s benefits to make an informed decision.

• Orthodontics is not a covered benefit under either plan.
• Important: If you and/or your dependent(s) are under the age of 19 and enrolled in the Student Health Insurance Plan, they will be automatically covered for pediatric essential dental benefits as part of the medical plan. Review the Pediatric Essential Dental Benefits for more information. If you and your dependent(s) are 19 or older, you will not have this coverage and will need to enroll in one of the optional dental plans.
• You will not be reimbursed for dental care services received abroad.

Need Help?

For more detailed information, including restrictions, review the Dental Plan Comparison Guide or contact Blue Cross Blue Shield at 1 (800) 257-8141. You will need to identify yourself as a Harvard student and the plan name that you are interested in learning about (Preventive vs. Comprehensive). 

Dentist Network

Both the Preventive and Comprehensive plans give you access to the same extensive network of dentists.  

How to find an in-network dentist:

Dentists that participate in the Dental Blue network submit claims directly to Blue Cross and accept either the dentist’s actual charge for covered services or the maximum amount allowed by Blue Cross Blue Shield of Massachusetts, whichever is lower. 

• Go to https://www.bluecrossma.org/
• Click find a doctor under "Find Care"
• Fill in all fields and select "Dental Blue" for your network
• Click the search button

You may also call Blue Cross Blue Shield at 1 (800) 257-8171 for assistance.

Harvard School of Dental Medicine - Harvard Dental Center participate as an in-network provider:

Harvard Dental Center - Cambridge Office
Faculty Group Practice
114 Mount Auburn Street, 7th Floor, Cambridge, MA 02138
Schedule an appointment by calling (617) 432-1434 or submit an Online Appointment Request

Harvard Dental Center - Longwood Office
Faculty Group Practice & Teaching Practice
188 Longwood Avenue, Boston, MA 02115
Schedule an appointment by calling (617) 432-1434 or submit an Online Appointment Request

Learn More: https://hsdm.harvard.edu/harvard-dental-center 

Your coverage out-of-network:

Members have the freedom to seek care from dentists who are out-of-network; however, your out-of-pocket costs will be higher. Blue Cross Blue Shield will only pay up to the allowed amount for covered services performed by an out-of-network dentist. You’ll be responsible for your normal cost-share and the difference between the dentist's actual charge and the allowed charge. You will also have to file for reimbursement. You will not be reimbursed for dental care services received abroad. 

REQUIRED DOCUMENTATION

We require documentation for each family member enrolled in the dental plan. Documents must be in English and are only required for initial enrollment (and are not necessary when you renew dependents for subsequent terms). 

• Married spouse: marriage certificate or I20 form for international students
• Dependent children: Birth certificate, legal documentation of adoption or guardianship, or DS-2019 form for international students

Submit your completed dental application and documentation to:

HUSHP Member Services Email:
mservices@huhs.harvard.edu

Extension School students should return their applications to the Extension School.

LIFE CHANGING EVENTS

We are unable to process applications received after the open enrollment deadline without a life changing event.

Coverage and cost will be pro‐rated to the day of the event.  

Documentation and enrollment applications must be received within 60 days of the event and the following is required:

• Official document of the event with your name (and/or name of dependents, if applicable) and the date of the event on the document 
• Submit documentation and enrollment application to Member Services by email at mservices@huhs.harvard.edu

Note: You are fully responsible to follow up with us to ensure that we received your application and request to enroll within 10 business days of enrollment if you do not hear from us.

Life Changing Event for Students: Other dental insurance coverage ending: A copy of the official insurance termination letter

Life Changing Events for Student Dependents: Students may enroll dependents due to a life changing event only when the student is already enrolled. Legal adoption or legal guardianship: Legal documentation of adoption or guardianship, or DS-2019 form for international students Marriage: Marriage certificate or I20 form for international students Dependent entry into the country: A copy of the dependent's passport with the entry date stamped for when the dependent arrived into the United States Other dental insurance coverage ending: A copy of the official insurance termination letter

Submit your completed dental application and documentation to HUSHP Member Services:

Office: (617) 495-2008

Email: mservices@huhs.harvard.edu

Web: www.hushp.harvard.edu