Blue Cross Blue Shield Supplement Policies Does It Pay for Dental

Dental Insurance Plans

Dependable and Affordable Dental Options for Individuals and Families

Did you know your dental health is linked to your overall health? Daily dental care and routine checkups can help you stay healthy. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers affordable dental plans in addition to great health care coverage.

Get Started

Blue Cross NC offers three dental plans to fit your budget and dental care needs. You can see what is covered for preventive, basic and major services in the What's Covered section below.

Which plan is right for you? With the two PPO plans you get richer benefits and better price points, in exchange for seeing dentists that are in the Blue Cross NC network. Individuals wanting to see a dentist who is not in the network may find the core plan to be a better fit.

Dental Blue for Individuals PPO:
Preventive Plan

Covers preventive services and savings on basic and major

Richer benefits in-network


$23.86

Per Member, Per Month
regardless of age

Start Shopping


You pay 0% of in-network preventive care services and 0% of the allowed amount on out-of-network preventive care services after $20 copay1

No deductible on in-network and $250 deductible on out-of-network basic and major services

You pay no more than 70% of the total bill for basic services – like routine fillings – when seeing an in-network dentist

You pay no more than 70% of the total bill for major services when seeing an in-network dentist



For out-of-network basic and major services, you pay a $250 deductible and most of the cost, including amounts above the allowed amount1


Visit an in-network dentist for better benefits, and they will file the claims for you plus you won't have to pay charges over the allowed amount.

Find an In-Network Dentist

Note: This PPO plan will pay a higher benefit in-network. You may owe amounts above the allowed amount on out-of-network services.

Dental Blue for Individuals PPO 1500:
Value Plan

Covers preventive, basic and major services

Richer benefits in-network


$34.45

Per Member, Per Month
under 65 years old

$42.75

Per Member, Per Month
65 years or older

Start Shopping


You pay 0% of in-network preventive care services and 30% of the allowed amount on out-of-network preventive care services1

$50 deductible in-network and $100 deductible on out-of-network basic and major services – $1500 annual maximum

You pay 20% of the negotiated rate for basic services – like routine fillings in-network and 50% of the allowed amount out-of-network

You pay 50% of the negotiated rate for major services when seeing an in-network dentist


For out-of-network major services, you pay 50% of the allowed amount and a $100 deductible


Visit an in-network dentist for better benefits, and they will file the claims for you plus you won't have to pay charges over the allowed amount.

Find an In-Network Dentist

Note: This PPO plan will pay a higher benefit in-network. You may owe amounts above the allowed amount on out-of-network services.

Dental Blue for Individuals:
Core Plan

Covers preventive, basic and major services

Same benefit level for contracted and non-contracted dentists


$35.95

Per Member, Per Month
under 65 years old

$44.35

Per Member, Per Month
65 years or older

Start Shopping


You pay 0% of the allowed amount on preventive care services1

$75 deductible on basic and major services – $1000 annual maximum

You pay 30% of the allowed amount for basic services – like routine fillings

You pay 50% of the allowed amount for major services


While you pay the same percentage in- and out-of-network, you may owe on costs above the allowed amount out-of-network1


Visit any dentist you want, but visiting an in-network dentist means they will file the claims for you and you won't have to pay charges over the allowed amount.

Find an In-Network Dentist

Note: This Core plan pays the same benefit percentage in- and out-of-network. You may owe amounts above the allowed amount on out-of-network services.

What's covered

Preventive

PPO Preventive Plan

  • Routine dental exams (twice per year)
  • Cleanings (twice per year)
  • Panoramic and bitewing X-rays
  • Fluoride treatments (up to age 18)
  • Sealants (ages 6-15)
  • Palliative emergency treatment

PPO 1500 Value Plan and Core Plan

  • Routine & problem focused dental exams (twice per year)
  • Cleanings (twice per year)
  • Panoramic, full-mouth and bitewing X-rays
  • Fluoride treatments (up to age 18)
  • Sealants (ages 6-15)
  • Space maintainers
  • Pulp testing
  • Palliative emergency treatment

Basic

PPO Preventive Plan

  • Routine fillings
  • Simple extractions
  • Stainless steel crowns
  • Pulp testing
  • Space maintainers (for members under the age of 16)
  • Problem-focused dental exams (twice a year)
  • Full-mouth x-rays

PPO 1500 Value Plan and Core Plan

  • Routine fillings
  • Simple extractions
  • Stainless steel crowns

Major

Applies to all three plans

  • Gingival curettage
  • Gingivectomy and gingivoplasty
  • Periodontal maintenance
  • Inlays/onlays
  • Porcelain crowns
  • Dentures
  • Bridges
  • Oral surgery
  • Endodontics

Deductible for basic and major services

PPO Preventive Plan

  • $0 for in-network services
  • $250 for out-of-network services

PPO 1500 Value Plan

  • $50 deductible for basic and major services in-network
  • $100 deductible for out-of-network

Core Plan

  • $75 deductible for basic and major services

Annual Maximum – amounts that Blue Cross NC pays for preventive, basic and major services apply to the Annual Maximum

PPO Preventive Plan

  • $5,0003

PPO 1500 Value Plan

  • $1,5003

Waiting Periods2

Blue Cross NC has waiting periods for some dental services.

PPO Preventive Plan

  • No waiting period on any services

PPO 1500 Value Plan and Core Plan

  • Preventive Services: No waiting period
  • Basic Services: 6-month waiting period
  • Major Services: 12-month waiting period

Start Shopping

It's easy to apply for a dental insurance plan online.

  1. ClickApply Now below
  2. Enter some information about yourself
  3. Submit your application

​Apply Now​

Already shopping for a Blue Cross NC health plan? Add a dental plan to your health plan application before submitting.

Need more help?

  1. Read our Frequently Asked Questions below
  2. Call us at 1-800-324-4973, Monday - Friday, 8 a.m. - 5 p.m.

Benefits of Buying a Blue Cross NC Plan


Plans are available in all 100 North Carolina counties

Checkups and cleanings are covered twice per benefit period

You can see any licensed dentist in North Carolina

There's no deductible for preventive care like routine checkups and cleanings1

Choose the plan that best meets your needs

Start Shopping

How it Works


Using your dental insurance couldn't be easier:

Choose a licensed dentist practicing in North Carolina

Make an appointment

Show your Blue Cross NC member ID card at the dentist's office

Though most dentist offices will file a claim for you, if they don't offer that service, you will need to file the claim.

Start Shopping

Frequently Asked Questions

Who's eligible for Dental Blue® for Individuals℠?

All applicants (both under and over 65) and their dependents (spouses, domestic partners, and/or children under the age of 26) are eligible. Applicants must also be a resident of North Carolina and must have not had a Dental Blue for Individuals policy in the last 12 months.

Can I add a dependent to my dental plan?

Dependents can be added to your dental plan at any time, however standard waiting periods, if applicable, will apply.

Is it possible to cover my child but not myself?

Yes, you may apply for dental coverage that covers your child only.

If I cancel my Dental Blue for Individuals coverage, how soon can I reapply?

Reapplying for coverage isn't permitted for 12 months from your policy's termination date.

Are my monthly premiums subject to change?

You may experience a change in your monthly premiums at the time of your annual renewal (January 1 of each year), or when you add or remove dependents.

What are my premium payment options?

Your initial payment can be made by credit card or bank draft. Subsequent monthly premium payments can be set up for credit card, bank draft or direct bill.

How do I file a dental claim?

Participating providers will file the claim on your behalf. If your dentist office does not file claims, you should pay the dentist in full and submit your claim to Blue Cross NC for reimbursement. Complete a dental claim form and mail it to us within 180 days from the date of your service.

Download dental claim form

Mail the completed claim form to:

Blue Cross and Blue Shield of North Carolina
Dental Claims Unit
P.O. Box 2100
Winston-Salem, NC 27102-2100

Will I get credit for my prior dental coverage?

Yes, Blue Cross NC may waive or reduce any applicable dental waiting period by the number of month of prior dental coverage. Proof of prior dental coverage with less than 63 days lapse in coverage is required.

You must have had full coverage for preventive, basic and major services. Preventive only, Discount Only or Dental Savings Plans do not count as full coverage for prior credit. The DBFI PPO Preventive plan offers a benefit for preventive, basic and major services, therefore members who enroll in the DBFI PPO Preventive plan will earn coverage credit.

Can I change which dental plan I have anytime?

You can only change your dental plan within 60 days of a qualifying life event, like marriage, divorce, etc, or during the open enrollment period for January 1st renewals each year. Standard waiting periods, if applicable, will apply.

Start Shopping

omalleytolde2001.blogspot.com

Source: https://www.bluecrossnc.com/shop-plans/dental-blue-individuals

0 Response to "Blue Cross Blue Shield Supplement Policies Does It Pay for Dental"

Post a Comment

Iklan Atas Artikel

Iklan Tengah Artikel 1

Iklan Tengah Artikel 2

Iklan Bawah Artikel