Dental and Vision Reference

Delta Dental PPO

UC SHIP Dental Coverage is through Delta Dental. Your Delta Dental ID number is your Anthem Blue Cross member ID without the alpha prefix. For example, if your Anthem ID is XDPCA1234567, you would drop the XDP and use CA1234567 as your member ID.

• $25 deductible for work (no deductible for preventive & diagnostic services 2x per year)
• $1,000 maximum per year for in-network Delta Dental PPO dentists
• $750 maximum per year for Delta Dental PPO dentists that are not in-network

Benefits & Covered Services with an in-network Delta Dental PPO dentist:

Diagnostic & preventive services covered at 100% include:

• Exams, cleanings, and x-rays

Basic services covered at 80% include:

• Fillings, posterior composites, sealants, endodontics (root canal), periodontics (gum treatment), oral surgery, and occlusal guards

Major services covered at 70% include:

• Crowns, inlays, onlays, cast restorations, prosthodontics, bridges, dentures, and implants

Not covered:

• Orthodontics and prosthetics 

Delta Dental Customer Service: 1-800-765-6003

Blue View Vision Insight 

UC SHIP Vision Coverage is through Blue View Vision. Your Blue View Vision ID number is your Anthem Blue Cross member ID without the alpha prefix.

For example, if your Anthem ID is XDPCA1234567, you would drop the XDP and use CA1234567 as your member ID.

In network providers:    

• $10 Co-pay for Routine Eye Exam  
• Eyeglass Frames up to $120 then 20% off remainder         
• Eyeglass Lenses $25 co-pay

Contact Lenses—disposable up to $120 (in lieu of glasses)

Contact Lens evaluation and fitting has additional charges due to level of complexity and type of contacts with charges ranging from $32-300.