Healthy Smiles plans are preferred provider organization (PPO) plans, giving you the flexibility to choose your provider and a chance to save money by selecting from Blue Cross of Idaho’s large network of contracting PPO dentists.
Blue Cross of Idaho's PPO network includes over 900 dental providers in Idaho who agree to offer covered services at costs that are at or below established maximum allowances. In other words, visiting a dental provider in the Blue Cross of Idaho PPO network stretches your benefits dollars and saves you money!
If you choose a dental provider outside our PPO network, you may pay the difference between the provider's charge and our maximum allowance, and any applicable copayment, deductible and coinsurance.
Each Healthy Smiles plan (Preventive, Plus, and Preferred) has something unique to offer individuals no matter your age—it’s suited for children and seniors alike. Here are a few items to keep in mind as you choose the plan that is best for you
- Benefit Period Coverage Limit - Healthy Smiles Plus and Preferred plans provide coverage for up to $1,000 per member, per benefit period*. Healthy Smiles Preventive plan has no benefit period coverage limit!
*A benefit period is the twelve months following your coverage effective date.
- Copayment - All Healthy Smiles dental plans cover 100% of the maximum allowance for in-network preventive dental services after a $20 copayment per visit.
- Deductible - There is an individual deductible of $50 per member per benefit period. The deductible does not apply to in-network preventive dental services. The benefit period family deductible is satisfied after three family members meet their individual deductible.
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
- You must be an Idaho resident
HEALTHY SMILES PREVENTIVE
Healthy Smiles Preventive covers preventive dental services with no maximum limits, no in-network deductibles and no waiting periods. Because Blue Cross of Idaho covers 100 percent of in-network preventive services after a $20 copayment, this plan is the best option if you’re looking for a low premium dental plan that encourages good oral habits that help maintain a healthy smile. Benefits include:
- Oral examinations – once in a six-month period
- Emergency oral examination
- Panoramic X-ray or full mouth series X-ray – one time in any five consecutive years
- Bitewing X-rays – once per benefit period
- Periapical X-rays
- Cleanings – regular cleaning or periodontal maintenance – once in a six-month period
- Fluoride treatment – one application per benefit period for eligible dependent children
HEALTHY SMILES PLUS
Healthy Smiles Plus fits most budgets while providing the same coverage as Healthy Smiles Preventive, plus the following basic dental services after satisfying a six-month waiting period and $50 deductible (in-network preventive services don’t apply to deductible).
- Sealants – limited to permanent posterior un-restored teeth for eligible dependent children under age 16; one time per tooth in any three consecutive benefit periods
- Fillings – same tooth surface restoration covered once in a two-year period
HEALTHY SMILES PREFERRED
If dental care is a top priority for you and your family, Healthy Smiles Preferred is the most comprehensive plan available. Healthy Smiles Preferred provides coverage for preventive, basic and major dental services, including the opportunity to carry over unused dental benefit dollars from one year to the next (dental maximum carryover).
Copayments, deductibles, waiting periods and maximum limits apply. Healthy Smiles Preferred includes the same preventive and basic dental services as Healthy Smiles Preventive and Plus, and the following major dental services after satisfying a 12-month waiting period and $50 deductible:
- Crowns, bridges, dentures, implants – five-year replacement
- Root canals
- Periodontics (treatment of gum disease)
- Dental Maximum Carryover—With Healthy Smiles Preferred, you can carry over unused benefit dollars (up to $250) from one benefit period to the next. You may carry over a total of $1,000. When you visit your dentist at least once, and use $500 or less for dental claims in a benefit period, we carry over up to $250 for future use. You can use carryover dollars to pay for covered dental services after reaching the benefit period maximum, saving you out-of-pocket expenses.