Dental Blue® PPO

Dental Blue PPO provides coverage up to a $1000 or $1500 benefit period maximum, depending upon the option you fee is right for you and your family. Preventive, basic and major dental care services are available. There is a six-month waiting period for basic services (i.e. fillings and extractions) and a 12 month waiting period for major services (i.e. periodontal services, root canals, crowns, bridges and dentures). A $50 deductible applies to out of network preventive services and all basic and major services.

Blue Cross of Idaho pays 100% of the maximum allowance for in-network preventive services after a $20 copay. There are no waiting periods on preventive services, which include cleanings, oral examinations and x-rays.

You may maximize your dental benefit dollars by seeking dental services from a dentist who is preferred provider organization (PPO) provider with Blue Cross of Idaho. These providers have agreed to accept Blue Cross of Idaho’s maximum allowances for covered services.

To complete this application you will need to know the following:

• Other coverage information
• Credit Card or bank checking information
  (You must pay the first months premium at time of application submission)
• Which plan you are applying for

Application Requirements

• You must be no older than 64 years of age
• You cannot currently have Blue Cross of Idaho dental insurance
• You must be an Idaho resident