What do I need to know about the Blue Dental℠ PPO network and my costs?
Who is this for?
Michigan residents who buy their own dental insurance and members who have Blue Dental coverage through an employer.
As a Blue Dental member, you have access to a network of dentists who provide lower costs for the services you receive. It's important to understand your dental plan and what coverage you have as it may impact which dentists you can see and your costs when using them.
Blue Dental PPO Plans
When you have a Blue Dental PPO plan, you have coverage from three networks of dental professionals:
- PPO in-network
- Blue Par Select℠
- Out-of-network
PPO in-network dentists are contracted to fully accept Blue Dental coverage. You can see dental providers in this network knowing your costs are the lowest.
When you see a Blue Par Select dentist, these dentists aren't in-network, but agree to participate with us. That means they submit your claim on your behalf to Blue Cross and accept our approved amount, saving you money.
Out-of-network dentists do not participate in any arrangement with Blue Cross. You may still see an out-of-network dentist, but you may have to submit your own claim for reimbursement. Since out-of-network dentists do not have contracts with Blue Cross, you'll have higher out-of-pockets costs.
Here’s how they compare. We’ll use the estimated cost of a filling based on prices in Southeast Michigan and a member who has a Blue Dental plan that covers fillings at 50 percent.
| Dentist’s fee is $185 | PPO in-network | Blue Par Select | Out-of-network |
|---|---|---|---|
| Your cost | $61 | $88.50 | $96.50 |
Blue Dental EPO Plans
If you have an EPO plan, it only covers care you get from PPO in-network dentists. There's no coverage when you see Blue Par Select or out-of-network dentists.
Choosing a plan
Although every dentist will accept Blue Dental PPO plans, your coverage may vary based on their network participation with PPO in-network dentists providing the most savings, Blue Par Select dentist providing some savings and out-of-network dentist providing the least savings for you as a member.
If you have a dentist you like who's not a PPO in-network dentist or there aren't many in-network dentists near you, a PPO plan may be better for you. If you are looking to maximize your savings and are comfortable using only in-network dentists, an EPO plan may be best for you.