Protect your overall health with dental coverage you can smile about. Along with good dental care each day, regular dental checkups can help detect, prevent, and treat gum disease and related problems. With Dental Blue for Individuals, you’re covered for a broad range of dental services!
| Type of Coverage | Member Responsibility |
| Preventive services: Routine oral exams and cleanings, bitewing X-rays, sealants (for members 6 to 15 years old), space maintainers (for members under 16 years old), pulp texting, fluoride treatment, (for members through 18 years old only), palliative emergency treatment at the dentist, emergency oral examinations at the dentist, other diagnostic and preventive services. *3 | NONE |
| Basic Services: Fillings, simple extractions, stainless steel crows and other basic services. *3 | 30% after deductible |
| Major Services: Gum therapy, root canals, oral surgery, inlays and onlays, crowns and bridges, dentures, and other major services. *3 | 50% after deductible |
| Annual maximum for all services *5: (per covered member) | $1,000 |
| Waiting Periods: Preventive services/ basic services/ major services | None/ 6 months/ 12 months |
| Deductible: Basic and major services | $75 |
For plan information, view brochure below.
Notes: 3 Refer to the member booklet for a full list of diagnostic and preventive, basic and major services.
5 Based on allowed amount. Annual maximum on all services is $1,000 (includes diagnostic and preventive, basic and major services).
