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
View Pediatric and Adult 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
For more than one child, multiply rate by number of children
$17.02 (1 adult)
$34.89 (2 adults)
$38.30 (subscriber and children)
$61.27 (family)
Deductible None $50 benefit specific deductible (individual)
Out-of-Pocket Limit $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 copaymentpreventive/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 and:
       Fillings
       Crowns
       Other restorative materials
$0 copaymentpreventive/diagnostic visit for services including:
       Dental exam
       Cleaning
       Diagnostic x-rays

50% coinsurance after deductible and 6 month waiting period for:
Simple extractions and routine dental surgery and:
       Fillings
       Denture and bridge repair
       Periodontics
Major Dental (Endodontics and Prosthodontics) 50% coinsurance
50% coinsurance after deductible and six month waiting period.

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.







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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 the Blue Pediatric Dental in order to meet essential health benefit requirements