Dental and Vision

New York State offers dental and vision benefits that are separate from NYSHIP. You can enroll in the dental and vision plans even if you do not have a NYSHIP health plan.

Find a Provider

When you choose a participating provider, you pay less than you would for out-of-network care. Use the directories to find in-network providers.

Out-of-Network Benefits

You can visit an out-of-network provider and submit a claim under the plan. However, you will pay more out of pocket and will not be reimbursed for the full cost.

Dental Claims

Anthem Dental Claim Form

Out-of-Network Reimbursement Schedule

Anthem Member Authorization Form

Vision Claims

Davis Vision Out-of-Network Claim Form

HIPAA - Authorization for Disclosure of Protected Health Information

What is Covered

Dental 

The New York State Dental Plan covers a range of services, from preventive care to surgeries. For a complete list of covered services, see your NYS Dental Plan Certificate of Insurance.

Vision 

The New York State Vision Plan covers vision exams, glasses or contacts, and some additional benefits. For a complete list of covered services, see your Vision Plan Book.

You may not know it, but if you are an employee of New York State, or a Participating Employer in the New York State Health Insurance Program (NYSHIP), you may have access to dental and vision coverage.

Before we go any further, it’s helpful to know that your dental and vision benefits depend on who you work for and your union or negotiating group.

If you are a New York State employee represented by CSEA, DC-37 or UUP, your coverage is provided through your union’s employee benefit fund.

If you are an employee of the Unified Court System or work for a Participating Employer, contact your health benefits administrator, or HBA, for information about your dental and vision coverage. Some Participating Employers have the New York State Dental Plan and the New York State Vision Plan. Others offer different coverage.

If you are a New York State employee represented by APSU, C-82, NYSCOPBA, PBA, PEF or PIA or if you designated Management/Confidential or an employee of the New York State Legislature, your coverage is offered through the New York State Dental Plan and the New York State Vision Plan.

The rest of this video focuses on the benefits available through the New York State Dental Plan and the New York State Vision Plan. It explains premium information, when dependents can be added, and a few other important details you should know.

Is there a premium for dental and vision coverage?

For New York State employees enrolled in the New York State Dental Plan or the New York State Vision Plan, there are no premiums.

Participating Employers may handle premiums differently, so check with your agency’s health benefits administrator.

If you are a New York State employee on leave without pay, contact your HBA—you may be required to pay premiums during that time.

When can I add dependents to my dental and vision plans?

If you have the New York State Dental Plan and New York State Vision Plan, you can add dependents at any time without a waiting period even if your dependents have coverage elsewhere.

Can I have dental and vision coverage for myself and my dependents without NYSHIP health insurance?

Yes, you and your dependents can have dental and vision coverage regardless of whether you or they have health insurance through NYSHIP.

If my spouse or domestic partner and I are both eligible for the New York State Dental Plan and the New York State Vision Plan, can we be on each other’s plan?

Yes, you can. As long as you are both eligible, you and your spouse or domestic partner can be covered on each other’s New York State Dental Plan and New York State Vision Plan.

What happens to my dental and vision coverage when I retire or otherwise leave benefits-eligible service?

When you leave benefits-eligible service, you can continue dental coverage through COBRA at group rates for up to 36 months or by enrolling in a direct-pay plan with the carrier. Continued vision coverage is only available through COBRA.

Dental & Vision Coverage

If you are an employee of New York State or a participating employer, you may have access to dental and vision coverage. Watch this video to learn more.

Who is Eligible

New York State employees in benefits-eligible positions are eligible for the dental and vision plans after they complete the benefit waiting period. You are not required to enroll in NYSHIP.

A couple sits together at a table with a laptop and some papers in front of them. The man has a pen in his hand and is pointing enthusiastically at the computer screen out of view.

Both plans offer individual and family coverage. Family coverage includes your spouse- or domestic partner and your children. You can add dependents to your dental or vision plan anytime without a waiting period.

Mutual coverage through your spouse or domestic partner’s plan is allowed, even if both are employed through New York State. This means that both partners can maintain family coverage for dental/vision and cover the other as a dependent. This results in each person having primary coverage through their own plan and secondary coverage through their partner’s plan.

NYS active enrollees pay no premiums for dental or vision coverage. When you leave State services, you can continue your dental and vision coverage for up to 36 months under COBRA. For dental coverage only, you also have the option to convert to a direct pay contract.

Find documents about your plan(s) in the Documents & Publications Library

Frequently Asked Questions

Yes, the New York State Dental Plan is now administered by Anthem Blue Cross, effective October 1, 2024. The New York State Dental Plan was previously administered by Emblem Health.

There were no changes to your dental benefits as a result of the change in administrators. To view your current New York State Dental Plan Certificate of Insurance, visit the Documents and Publications Library.

To find out if your preferred provider participates in the Anthem network, visit anthembluecross.com/nys-dental.

If you are a New York State Dental Plan enrollee, select "New York State Dental Plan" under Search for a Dental Provider. You will be directed to the XPO Dental Complete network where you can search for providers by address, doctor name or specialty type.

If you are a Student Employee Health Plan (SEHP) New York State Dental Plan enrollee, choose "New York State Dental Plan Student Employee Health Plan- SEHP" under Search for a Dental Provider. You will be directed to the XPO Dental Complete network where you can search for providers by address, doctor name or specialty type. You can filter network results or click on the link for "Dental Discount Program Providers" to view providers who may charge you less than their normal fee for services not reimbursed by the SEHP New York State Dental Plan.

There are some situations where a provider may not be listed, so you can also call Anthem's dedicated New York State Dental Plan toll-free number, 1-833-821-1949, to check participating status.

You can complete the New York State Dental Plan Provider Nomination Form available on anthembluecross.com/nys-dental. The completed form can be submitted to the email address listed on the form.

Yes. You can securely log-in to the NYS Dental Plan website at anthembluecross.com/nys-dental. If you currently have active Empire Plan coverage and have previously set up an account with Anthem to view your Hospital Program benefits, you can use your existing username and password. You can view both your Hospital Program benefits and your dental benefits through the same web portal. If you are a new user, you will need your Anthem Dental Plan ID number, which is located on the front of your ID card, to register for an account. Once registered, you will be able to view your dental benefits and eligibility information.

Anthem also has a Sydney Health mobile app that you can download to your phone or tablet. More information is available at anthembluecross.com/nys-dental.

Please call Anthem's dedicated New York State Dental Plan toll-free number at 1-833-821-1949. You can also securely log in to the New York State Dental Plan website at anthembluecross.com/nys-dental or via the Sydney Health mobile app. Click "ID Cards" on the top of the page and then choose the option to print, email, fax, mail or download your current New York State Dental Plan ID card.

For NYS Enrollees:

Anthem Dental ID card for NYS Enrollees


 

For Student Employee Health Plan (SEHP) Enrollees:

Anthem Dental ID card for SEHP Enrollees

Yes, Anthem offers Direct Pay policies for eligible members. Individuals can enroll at any time and coverage will be effective on the first of the month following the date they apply. To find out more about available options, visit anthem.com/ny/individual-and-family/dental-insurance.

You should contact the Employee Benefits Division at 1-800-833-4344. If your COBRA plan has expired, or if you want more information about Anthem's Direct Pay policy, please visit anthem.com/ny/individual-and-family/dental-insurance or call the dedicated Anthem NYS Dental Plan toll-free number at 1-833-821-1949.

The dedicated Anthem NYS Dental Plan toll-free number is 1-833-821-1949.

If you are having difficulty finding a participating dental provider near your home address, please reach out to the dedicated Anthem NYS Dental Plan number at 1-833-821-1949 for assistance.

Contact your agency health benefits administrator for information about continuing coverage under COBRA.