Dental Benefits and Dental Claim Status
Dental Claim Form
Save yourself time and money by accessing your benefit information online. You can access a benefit summary, certificate of coverage, pending and paid claims, pretreatment estimates and the status of plan maximums and deductibles.
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Access a printable dental claim form. Just complete the form and fax it to 402-467-7336 or mail it to Ameritas Life Insurance Corp, Group Claims, PO Box 82520, Lincoln NE 68501. When you see a provider in the Health Center, no claim form is needed. The Health Center will complete the claim form and file your claim for you.
Download and/or print an ID card.
Authorization for Release of Protected Information
This printable form can be used to authorize the release of your protected health information.
University Health Center Dental Office
By choosing one of the University Health Center Dental Office PPO providers, you will receive the maximum benefit under your plan.
UNL Healthy Option Student Plan
Information about plan enrollment.