2017 Pediatric & Adult Dental Plans

 

Dental care is important to your overall health. That's why our dental plans include comprehensive oral health coverage. You can purchase a dental plan with your BlueCross BlueShield individual or family plan, or separately. 

  • New for 2017 - Blue Value Dental 3, a richer plan with coverage for cosmetic orthodontics (routine braces) for children and adults.
  • Blue Pediatric dental benefits and cost-sharing are included in all Blue Value dental plans. Pediatric Dental is an essential health benefit as outlined in the Affordable Care Act. 
  • You have the flexibility to see out-of-network dentists. 

View Pediatric and Adult Plans
View Blue Pediatric Dental
View Blue Value Dental 1
View Blue Value Dental 2
View Blue Value Dental 3

 

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

 

Ready to enroll?
Call us at 1-800-888-5407 and we'll help you find the plan that's right for you. 

 

 

   Blue Pediatric Dental* (PPO)
 Blue Value Dental 1* (PPO)  Blue Value Dental 2 (PPO)
 Blue Value Dental 3*** (PPO)
Monthly Premium $21.07 (per child) $20.55 (one adult)
$41.10 (two adults)
$52.82 (subscriber and child(ren))
$84.57 (family)
$27.70 (one adult)
$55.40 (two adults)
$63.93 (subscriber and child(ren))
$104.00 (family)
$31.70 (one adult)
$63.40 (two adults)
$71.80 (subscriber and child(ren))
$117.15 (family)
Benefits Children to age 19 years Adult/Family** Adult/Family** Adult/Family**
Deductible (embedded) N/A $50 per member/$150 family maximum (per calendar year)

$50 per member/$150 family maximum (per calendar year)

$50 per member/$150 family maximum (per calendar year)

Annual benefit maximum N/A $750 per member per calendar year $1,250 per member per calendar year $1,500 per member per calendar year
Out-of-pocket maximum $350 - 1 child, $750 - 2 or more children (per calendar year) N/A N/A N/A
Orthodontic Lifetime Maximum (pediatric and adult cosmetic - routine braces) N/A N/A N/A $1,000 per member per lifetime
Preventive/diagnostic care (exam, cleaning, x-rays) $20 copayment $0 copayment $0 copayment $0 copayment
Basic restorative
(fillings, extractions, periodontics, endodontics)
50% coinsurance 50% coinsurance after deductible 20% coinsurance after deductible 20% coinsurance after deductible
Major dental
(bridges, crowns, dentures)
50% coinsurance 50% coinsurance after deductible 50% coinsurance after deductible 50% coinsurance after deductible
Orthodontic services (medically necessary)

50% coinsurance applies to children age 19 50% coinsurance applies to children age 19 50% coinsurance applies to children age 19 50% coinsurance applies to children age 19
Orthodontic services (cosmetic - routine braces)  N/A N/A N/A 50% coinsurance applies to children and adults
 
 

 

 

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

*Available on NY State of Health Marketplace

**Blue Pediatric dental benefits and cost-sharing are included in all Blue Value dental plans. Pediatric Dental is an essential health benefit as outlined in the Affordable Care Act. As an insurer, we are required to make our best efforts to ensure that you obtain this coverage. 

***Blue Value Dental 3 includes coverage for children to age 19 for medically necessary orthodontics subject to an out-of-pocket maximum and cosmetic orthodontics (routine braces) subject to a lifetime maximum per member. Adults and adult dependents (19 to 26 years) have coverage for cosmetic orthodontics (routine braces) subject to a lifetime maximum per member.