2016 Stand Alone Pediatric & Adult Dental Plans

 

BlueCross BlueShield of Western New York offers stand-alone pediatric and adult dental plans for small groups administered by us effective on the group's renewal date in 2016.  Our plans provide essential health benefits to ensure members receive comprehensive oral health coverage through our own dental network. This replaces our former Healthplex offering. You now have flexibility to see out-of-network dentists. You will have one ID card when you also have a medical plan with us.

View Pediatric and Adult Dental Plans

View Blue Pediatric Dental

View Blue Value Dental 1

View Blue Value Dental 2 

Looking for a dental provider?  
Use our Find a Provider search tool for our Pediatric & Adult Dental Plans - You can search by specialty, zipcode, city, county or state.  Just select "Dental Providers" in the dropdown.

 

Dental benefits Blue Pediatric Dental* (PPO) Blue Value Dental 1* (PPO)
Blue Value Dental 2 (PPO)
Monthly Premium $18.21 (per child) $17.90 (one adult)
$35.79 (two adults)
$46.18 (subscriber and child(ren))
$64.50 (family)
$22.19 (one adult)
$44.39 (two adults)
$53.11 (subscriber and child(ren))
$75.29 (family)
Deductible N/A $50 per member
Applies to basic restorative and major dental services
$50 per member
Applies to basic restorative and major dental services
Preventive/diagnostic care
(exam, cleaning, X-rays)
$20 copayment $0 copayment $0 copayment
Basic restorative
(fillings, extractions, periodontics, endodontics)
50% coinsurance 50% coinsurance after deductible 20% coinsurance after deductible
Major dental
(prosthodontics, crowns, dentures)
50% 50% coinsurance after deductible 50% coinsurance after deductible
Orthodontia
(medically necessary, routine braces not included)
50% coinsurance Not covered Not covered
Annual maximum N/A $750 per member, per plan year $1,000 per member, per plan year
Out-of-pocket maximum $350 - 1 child
$700 - 2 or more children (per plan year)
N/A N/A
       
     
  Shop Plans

Shop Plans

 
 

 

 

 

Non-participating provider services are not covered except as required for emergency care.

 

*Available on SHOP

Note: Blue Pediatric dental benefits and cost-sharing are included in all Blue Value dental plans.

 

BlueCross BlueShield of Western New York offers stand-alone pediatric and adult dental plans for small groups. Our plans provide essential health benefits to ensure members receive comprehensive oral health coverage. We partner with and utilize the HealthPlex network to service our Adult and Pediatric plans. HealthPlex is the largest dental benefits administrator in New York. These plans will no longer be available in 2016.

View Adult Dental Plan Overviews
View Pediatric Dental Plan Overviews

Looking for a dental provider?  You can search by specialty, zipcode, city, county or state.  
Find a Dental Provider for our Pediatric & Adult Dental Plans

 

   Blue Pediatric Dental
Blue Value Dental*
Monthly premium $15.78 (per child)
For more than one child,
multiply rate by number of children
$ 16.41 (employee)
  $ 33.64 (employee & spouse/domestic partner)
$36.92 (employee & children)
$59.08 (family)
Deductible None $50 benefit specific deductible (individual)
Out-of-Pocket maximum $350 (one child) / $700 multiple children Unlimited
Benefit maximum
N/A $750 per member, per plan year 
Preventive/routine dental care
*One dental exam and one cleaning per six month period
$20 copayment per preventive/diagnostic visit for services including:
       Dental exam
       Cleaning
       Topical fluoride
       Sealants
       Space maintainers
       Diagnostic x-rays

   50% coinsurance for:
       Simple extractions and routine dental surgery
       Fillings
       Crowns
       Other restorative materials
$0 copayment per preventive/diagnostic visit for services including:
       Dental exam
       Cleaning
       Diagnostic x-rays

50% coinsurance after deductible for:
       Simple extractions and routine dental surgery
       Fillings
       Denture and bridge repair
       Periodontics

Major Dental

(Endodontics and Prosthodontics)

50% coinsurance 50% coinsurance after deductible
Orthodontia 50% coinsurance 50% coinsurance after deductible (for members up to age 19)
  Non-participating provider services are not covered except as required for emergency care. Non-participating provider services are not covered except as required for emergency care.
     
     
  SHOP plans

SHOP plans

 

 

 

Non-participating provider services are not covered except as required for emergency care.

*All children under the age of 19 enrolled in Blue Value Dental will be covered under Blue Pediatric Dental in order to meet essential health benefit requirements.