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.
 

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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

Dental and Vision

Your union offers dental and vision benefits through an employee benefit fund. Reach out to your union to learn more.

District Council 37 Employee Benefit Fund
212-815-1234

Call your union for dental and vision care insurance and other union benefits. Call for information about continuing dental and vision care coverage under COBRA.