BCBSIL Dental Plans


Blue Cross BlueShield of Illinois
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Optional Dental Plan

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With the BCBSIL dental plan, you’ll get dental coverage on day one with no deductible deductible required for check-ups, cleanings and other preventive services. Most important, costs are typically reduced when you receive care from any of our participating network dentists. However, you also have the option to see any dentist not in the network, but your out-of-pocket costs may be higher.

With BlueCare® Dental PPO, you’ll get:
  • One of the highest maximum annual benefit levels available – up to $1,500 per person per year
  • Up to a 20% discount, up to a maximum savings of $1,000 for orthodontic services at participating dentists

For more information on coverage and benefits, view the BlueCare Dental Outline of Coverage 

You must enroll in a BCBSIL health plan in order to enroll in the dental plan (you have up to 31 days from the effective date of your policy to enroll). Shop for a plan now.

Eligibility Requirements

  • You must enroll in a BCBSIL health plan in order to enroll in the dental plan (excluding SelecTemp PPO). You have up to 31 days from the effective date of your policy to enroll.
  • All members on that health plan must be enrolled in BlueCare Dental PPO.
  • Once your dental plan is dropped for any reason, you cannot re-enroll unless you reapply for a new health insurance plan.

Monthly Rates

Zip codes 600 – 608
Member $30.55
Member + Spouse $61.05
Member + Child(ren) $52.35
Family $89.55
Zip codes 609 – 629
Member $28.80
Member + Spouse $57.60
Member + Child(ren) $49.40
Family $84.45

How to Enroll

There are three ways to enroll in BlueCare Dental PPO:

  • Select ‘YES’ next to the Dental option when you apply online for any qualifying Blue Cross and Blue Shield of Illinois health plan. (excluding SelecTemp PPO).
  • Call Blue Cross and Blue Shield of Illinois toll-free at (800) 477-2000 (8 a.m. to 6 p.m., CT, Monday – Friday).
  • Contact your local independent health insurance agent.

BlueCare® Dental PPO

Benefits1 Participating Dentists Non-Participating Dentists2
Deductible
Deductible applies to Type III Services Only
$50 per member per benefit period;
$150 maximum per family
Calendar Year Maximum Benefit
(per individual)
$1,5002
Type I Services
Cleanings
Examinations
X-rays
Sealants
Space maintainers
100% of Maximum Allowance 50% of Maximum Allowance
Type II Services
Fillings
Simple Extractions
80% of Maximum Allowance 50% of Maximum Allowance
Type III Services
Bridges3
Crowns3
Dentures3
Endodontics
Oral Surgery
Periodontics
50% of Maximum Allowance after deductible 50% of Maximum Allowance after deductible
Orthodontics
Not an insured benefit. Up to a 20% discount, up to a maximum savings of $1,000, is available to you for services received from a participating dentist.
Up to a 20% Discount, up to a maximum savings of $1,000 Not Available

1. Your dental care benefits are highlighted in this chart. To fully understand all the terms, conditions, limitations and exclusions exclusions which apply to your benefits, please read the entire BlueCare Dental PPO Rider.

2. For services received from a non-participating dentist, the member will be responsible for any difference between the dentist’s charges and the maximum allowable charge allowable charge. The maximum allowable charge is based on our network negotiated fees. Further information regarding the maximum allowable charge and network status of dentists is available by calling the toll free telephone number on the back of your dental identification card.

3. Benefit Waiting Period – You must be continuously covered under your rider for twelve (12) months before being eligible for the following covered services: (1) Major Restorative Services; (2) Prosthodontic Services; and (3) Miscellaneous Restorative and Prosthodontic Services.

BCBSIL Dental – Comparison Chart

BlueCare Dental 1A BlueCare Dental 4 Kids 1A BlueCare Dental 1B BlueCare Dental 4 Kids 1B
Benefit Summary Benefit Summary Benefit Summary Benefit Summary
In Network Out of Network In Network Out of Network In Network Out of Network In Network Out of Network
Deductible (family x3) $50 $50 $50 $50 $75 $75 $75 $75
Annual Maximum $15002 $15002 $10002 $10002
Diagnostic Evaluations 100%3 70%3 100%3 70%3 90%3 70%3 80%3 60%3
Preventive 100%3 70%3 100%3 70%3 90%3 70%3 80%3 60%3
Diagnostic Radiographs 100%3 70%3 100%3 70%3 90% 70% 80% 60%
Misc. Preventive Services 80% 50% 80% 50% 70% 50% 80% 60%
Basic Restorative 80% 50% 80% 50% 70% 50% 50% 30%
Non-Surgical Extractions 80% 50% 80% 50% 70% 50% 50% 30%
Non-Surgical Periodontal 80% 50% 80% 50% 70% 50% 50% 30%
Adjunctive Services 80% 50% 80% 50% 70% 50% 50% 30%
Endodontics (root canal) 80% 50% 80% 50% 70% 50% 50% 30%
Oral Surgery 80% 50% 80% 50% 50% 30% 50% 30%
Surgical Periodontal 80% 50% 80% 50% 50% 30% 50% 30%
Major Restorative 50% 30% 50% 30% 50% 30% 50% 30%
Prosthodontics 50% 30% 50% 30% 50% 30% 50% 30%
Misc Restorative & Prosthodontics Services 50% 30% 50% 30% 50% 30% 50% 30%
Orthodontics (up to age 19) 50% 30% 50% 30% 50% 30% 50% 30%
Out of Pocket Maximum7 $350 for one child / $700 for 2+ children $350 for one child / $700 for 2+ children $350 for one child / $700 for 2+ children $350 for one child / $700 for 2+ children
Rates
Region 1 Region 2 Region 1 Region 2 Region 1 Region 2 Region 1 Region 2
Primary Applicant $33.335 $27.005 $42.115 $34.115 $27.705 $22.445 $33.025 $26.755
Member + Spouse $66.665 $54.005 N/A5 N/A5 $55.405 $44.885 N/A5 N/A5
Member + 1 Child $75.445 $61.115 N/A5 N/A5 $60.725 $49.195 N/A5 N/A5
Family $192.995 $156.335 N/A5 N/A5 $154.465 $125.135 N/A5 N/A5
  1. This document does not contain a complete listing of the exclusion, limitations and conditions that apply to the benefits shown. For full information refer to the member’s certificate of benefits booklet.
  2. Annual maximum does not apply to members up to age 19.
  3. Deductible is waived.
  4. Rates are subject to change.
  5. Region 1 rates apply to members residing in the following counties: Cook, DuPage, Kane, Lake, and McHenry
  6. Region 2 rates apply to all members residing in counties outside Region 1
  7. Out of Pocket Maximum only applies to members up to age 19.
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