Questions Regarding the Dental Option

What dental options are available to me when I enroll in a Medicare Supplemental policy with BCBSKS? 
We offer a plan called DentalPlus.

What does DentalPlus cover? 
The following services are covered at 100 percent, to an annual maximum benefit payment of $1,500 each calendar year:

  • Oral examinations—two per year
  • Prophylaxis, including cleaning, scaling and polishing—two per year
  • Bitewing x-rays—two per year
  • Full mouth x-rays—one x-ray during a five year period

The following services are covered at 80 percent following a $50 deductible, to an annual maximum benefit payment of $1,500 each calendar year:

  • Simple extractions
  • Fillings (except gold)
  • Root canal treatment
  • Periodontic treatment of the gums
  • Extractions of impacted teeth
  • Repair of dentures
  • General anesthesia when the dental treatment is a covered service

The following services are covered at 50 percent following a $50 deductible, to an annual maximum benefit payment of $1,500 each calendar year and a 12-month waiting period:

  • Crowns
  • Onlays
  • Bridges
  • Dental implants
  • Dentures
  • Oral/periodontal surgery

Teeth whitening services pay $200 annually for whitening services and supplies provided by a dentist, to a maximum benefit payment of $1,500 each calendar year.

How much is DentalPlus? 
The 2024 monthly premium for DentalPlus for an individual age 65 and over is $50.48.

The monthly premium for DentalPlus PPO for an individual age 65 and over is $42.25.

Is there a waiting period? 
Yes, the following services do have a 12-month waiting period from the effective date of coverage:

  • Crowns
  • Bridges
  • Dentures
  • Onlays
  • Dental implants
  • Oral/periodontal surgery

Does DentalPlus cover dentures? 
Yes, following a 12-month waiting period from the effective date of coverage. Dentures are covered at 50 percent following a $50 deductible and are subject to the annual benefit maximum per calendar year.

What if my dentist is not in the network? 
If you use a non-contracting dentist, you will be reimbursed at 80 percent of the maximum allowable payment made to a contracting dentist for the same service. You may need to pay for any charges over the dental plan's allowance in addition to any deductible and coinsurance of the program.

Can I cancel a DentalPlus policy at a later time? 
Yes, you may cancel your dental policy at any time. However, when you choose to enroll at a later date, you will have to reserve the waiting period.

If I do not enroll in DentalPlus at initial enrollment, can I enroll at a later time? 
Yes, our dental policies are available for purchase at any time.

Does DentalPlus have a deductible? 
There is a $50 annual deductible on some services. Please see the "What does DentalPlus cover?" section above for more information.

Does the deductible apply to the two yearly checkups? 
No, your two yearly checkups are covered at 100 percent.

Can I just get DentalPlus? 
Yes, our DentalPlus policy is available for purchase at any time and does not require you to have other coverage before applying for dental coverage. For more information, visit individual and family dental insurance.

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