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Flexible Blue Dental PlusSM

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Flexible Blue Dental PlusSM Benefits-at-a-Glance

Download Flexible Blue Dental Plus Benefits (62K PDF)
Class I — Preventive services
Oral exams, bitewing X-rays, teeth cleanings and fluoride Covered — 75% twice per calendar year (90-day benefit waiting period applies).
Class II — Restorative services
Replacement fillings and onlays, crowns, extractions and root
canal therapy
Covered — 50% of the approved amount; subject to frequency limitations (90 day benefit waiting period applies)
Benefit maximum
The benefit maximum limits the amount payable for services each calendar year. Once a member reaches the benefit maximum, services will not be paid for that member for the balance of the calendar year. We will continue to pay claims for other eligible members until each member has reached the maximum. $800 per member, per calendar year
Note: The 90-day benefit waiting period for Class I and II services is waived with proof of creditable coverage.

Note: Flexible Blue Dental Plus is optional coverage that may be purchased with Individual Care Blue PlusSM or Flexible Blue IISM plans. Members may choose a DenteMax network dentist. If a member chooses to receive care outside the DenteMax network, their out-of-pocket costs may be higher.

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