Keeping up with dental checkups is just as important as you age as it was when you were a kid. Regular checkups not
only keep your teeth healthy, but they also can detect more serious health problems. That makes having a dental plan
a pretty bright idea — and Anthem Student Advantage makes it budget friendly.
* This is not a contract; it is a partial listing of benefits and services. All covered services are subject to the conditions, limitations, exclusions, terms, and provisions of your certificate of coverage. In the event of a discrepancy between the information in this
summary and the certificate of coverage, the certificate will prevail.
Sydney Health is offered through an arrangement with CareMarket, Inc., a separate company offering mobile application services on behalf of <Anthem Blue Cross and Blue Shield> ©2021-2022.
Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield
Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE®
Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain
affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire:
Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health
Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin
(BCBSWI), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation
(WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem
Insurance Companies, Inc.>
<124136xxMENxxx> BV Rev. 01/22
Who is eligible?
All students and their dependents
can enroll in an individual dental
plan. Students must manually sign
up each Fall during open enrollment,
which ends 9/6/24.
Find a dentist, check costs, and
ask questions online?
• Sydney
SM
Health app. Find
dentists in your plan and view
claims right from your phone.
• Dental care cost estimator. Look
up costs for common procedures
and treatments from dentists in
your plan network, so you know
what to expect.
• The TeleDentists®. Live chat or
video visit with a board-certified
dentist, 24/7. Go to Find Care and
search The TeleDentists.
• Dental health risk assessment.
This quiz can help you better
understand your oral health and
risk factors for tooth decay, gum
disease, and oral cancer.
Keep your
smile healthy
and bright
With a dental plan from
Anthem Student Advantage
Dental benefits at a glance*
School session -
Spring Only
Student
Student &
Spouse
Student &
Child(ren)
Student,
Spouse &
Child(ren)
Domestic Students
1/15/2025 - 8/14/2025
$94.43 $188.86 $188.86 $283.29
International/
Medical Students
1/1/2025 - 7/31/2025
$94.43 $188.86 $188.86 $283.29
Benefit information
Dentist
in your plan
Dentist not
in your plan
Total benefit amount per year $750 $750
Annual deductible
(deductible waived for diagnostic and
preventive services)
$50 $50
Diagnostic and preventive services
(routine cleanings, X-rays, fillings,
oral exams)
Plan pays 100%
Plan pays 100% of the
max allowed by your
plan
Basic restorative services
(consultation, amalgam fillings, space
maintainers)
Plan pays 80% of
cost, you pay 20%
Plan pays 80% and you
pay 20% of the max
allowed by your plan
Major restorative services
(crowns, bridges, dentures,
oral surgery, root canals)
Not covered Not covered
Nonsurgical periodontics
(see plan for specifics)
Plan pays 80% of
cost, you pay 20%
Plan pays 80% and you
pay 20% of the max
allowed by your plan
