Stand Alone Pediatric & Adult Dental Plans

BlueCross BlueShield of Western New York offers stand-alone pediatric and adult dental plans for individuals. 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 State.

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 $14.61
For more than one child,
multiply rate by number of children
$ 13.70 (1 adult)
  $ 27.40 (2 adults)
Deductible None $50 benefit specific deductible (individual)
Out-of-Pocket Limit $700 individual / $1400 family 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 flouride
       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

20% coinsurance after deductible for:
       Simple extractions and routine dental surgery
       Fillings
       Denture and bridge repair
       Periodontics
Major Dental (Endodontics and Prosthodontics) 50% coinsurance Endodontics are covered at 20% coinsurance after deductible.

Prosthodontics, inlays and onlays, crowns and all other major restorative services are not covered.
Orthodontia 50% coinsurance Not covered

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.







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