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New Options for Affordable Health Insurance

 

Preferred Blue® Dental

Preferred Blue Dental is a Preferred Provider Organization (PPO) plan that utilizes our PPO network of providers. Preventive, basic and major care services are covered and there is an annual maximum of $1,000, $1,250 or $1,500.

 

 

 Option 1  

 Option II 

 Option III 

 

 In-Network

 Out-of-Network

In-Network

 Out-of-Network

 In-Network

 Out-of-Network

Preventive Care

 100%

 80%

 80%

 80%

 80%

 50%

Basic Care

 80%

 70%

 80%

 70%

 80%

 50%

Major Care

 50%

 40%

 50%

 40%

 50%

 50%

Deductible

$25 or $50 

$25 or $50  

$25 or $50

Annual Maximum

$1,000, $1,250 or $1,500

$1,000, $1,250 or $1,500

$1,000, $1,250 or $1,500

Deductible
There is an annual deductible of $25 or $50 per person per year, depending on the plan that you select. This deductible applies to in-network and out-of-network services for Basic and Major care benefits, and Preventive care benefits for out-of-network services. When three insured family members have satisfied their deductibles, all other insured family members are immediately eligible for benefits.

Preventive Care Benefits
Preferred Blue Dental pays a designated percentage of the maximum allowance for routine dental care benefits. Available benefits include two annual oral exams, x-rays, cleanings, fluoride treatments and treatment-related sealants for certain teeth. Certain benefits are only available to dependent children with age maximums.

Basic Care Benefits
Basic care benefits cover frequently used services such as fillings and pin retentions, simple extractions, oral surgery, root canal therapy and periodontal maintenance. After the calendar year deductible is met, the program pays a designated percentage of the maximum allowance, depending upon your employer’s plan. Depending upon the plan chosen, there may be a six-month waiting period for basic services.

Major Care Benefits
Major care benefits of Preferred Blue Dental include prosthetic and restorative treatments such as crowns and crown repair, bridgework and repair of bridgework, dentures (repair, adjustment, relining), inlays and onlays, and cast porcelain restorations. The plan will designate a percentage of the maximum allowance to be covered after the calendar year deductible is met. Depending upon the plan chosen, there may be a 12-month waiting period for major services.

Optional Orthodontic Benefits
Orthodontic benefits are available to groups that have 20 or more enrolled employees. Benefits for orthodontic services are available only to insured dependent children, with age maximums as stated in the employer's plan. The orthodontic option pays 50% of the maximum allowance for covered services up to a lifetime benefit limit of $1,000, $1,250 or $1,500 per enrolled elligible dependent child. Benefits are provided for installation of appliances to straighten teeth and to correct abnormally positioned teeth. You may choose between a 12 or 24 month waiting period.

For more information on group dental plans click here. You can also contact your insurance agent or your local Blue Cross of Idaho district office for more information.

This outline is a brief description of the coverage issued to the group. This is not a contract. The policy describes in detail the rights and obligations of both the group and Blue Cross of Idaho under the group policy. It is important that you read the policy carefully. The benefits of the policy are governed primarily by Idaho law.