THE UFT/SIDS ADVANTAGE

The UFT Welfare Fund Participating Dentist Program is designed to provide you with comprehensive dental services while reducing or eliminating your out-of-pocket expenses.

If you or a member of your family who is covered for dental benefits wish to use a Participating Dentist, select one from the Directory of Participating Dentists and call for an appointment. You can also search for a participating dentist on this website. Be sure to identify yourself as an eligible member of the United Federation of Teachers Welfare Fund and confirm that the dentist is a UFT/SIDS Participating Dentist. Be aware that although several dentists practice at the same location, only the dentist whose name appears in this Directory is a UFT Participating Dentist.

This program was developed in cooperation with SIDS Consultants, who monitor the performance of participating providers to ensure that appointments are freely given and honored and that charges for services do not exceed Maximum Charges listed in the UFT Welfare Fund Dental Schedule.

When you obtain your services from a Participating Dentist it does not in any way change the nature of your dental plan. Plan coverage and allowances are the same for services provided by a participating or non-participating dentist. If you use a non-participating dentist, the Fund will pay up to the maximum allowance set forth in the dental schedule and you will be responsible for the difference between that allowance and your dentist’s charge.

If you use a Participating Dentist, the Fund will pay your dentist directly and you will not be required to pay the dentist any money except in the following few instances.

For a covered, but non-reimbursable service.

There are services listed in the dental schedule, which, at times, are not payable by the plan. For example: restorations for cosmetic improvement; services for which the Alternate Benefit Provision is applied; where frequency limitations and/or plan maximums have been met. In these instances the Participating Dentist may not charge more than the Dental Schedule would have paid for those services, plus any applicable co-payments.

For a specified co-payment.

You are responsible to pay the dentist the patient co-payment amount listed in the Dental Schedule for certain high-cost services (crowns, bridges, dentures, root therapy, orthodontic treatment, intravenous anesthesia and treatment appliances).

For a non-covered service.

The Participating Dentist may not charge you more than his/her usual and customary charge for services that are not covered by the Dental Plan.

For Dental Implants: The surgical placement of an implant is not a covered expense. However, participating dentists have agreed to limit their charge for the placement of an implant to $1,200. Refer to the UFT Welfare Fund Dental Schedule Item 14: UFT Discount On Non-Covered Service.

The restoration or prosthesis placed on an implant is not covered. However, the plan will provide a Special Reimbursement to offset part of the cost for that service. Refer to the Dental Schedule Item 15: Special Reimbursement.

Your dental plan applies certain payment limitations based on frequency. For example, the plan will not pay for more than one oral examination in a six month period, or more than one prophylaxis in a three month period. Since it is not possible to determine in advance whether benefits will be available for these services, the dentist is entitled to request payment from you pending submission and adjudication of claim. If benefits are available, that money will be refunded.

If you are eligible for dental benefits under another group dental plan in addition to the UFT Welfare Fund Dental Plan, the dentist is entitled to the benefits available from both plans. The combined payment for any procedure may not exceed the dentist’s usual and customary fee, and payment from the second plan will be applied first to reduce or eliminate any out-of-pocket expenses.

It is important to understand that neither SIDS nor the UFT Welfare Fund recommends any particular dentist. You are responsible to select the dentist of your choice, and should exercise the same care and apply the same criteria in selecting a Participating Dentist that you would in selecting a non-participating dentist.

Maintaining high standards of care and patient satisfaction is fundamental to the success of this program. To help in this regard, we ask for your input. Please complete the member satisfaction survey .

If you need any help or have questions, concerns or suggestions regarding the program, please contact:

SIDS

P.O.Box 9005

Lynbrook, NY 11563-9005

516-394-9408
866-679-7437

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