Dental Insurance for Individuals and Families

If you did not enroll in this optional program at the time you enrolled in a health program or if you do not have BCBSKS health coverage at this time, you may apply for dental coverage as a separate benefit during specific open enrollment dates.

  • During 2014:
    • Individuals under age 65 may enroll during January, February, July and August.
    • Those over age 65 may enroll during March, April, September and October.

Rates

  • Individual under 65: $31.76
  • Individual + Children: $71.68
  • Individual + Spouse: $77.82
  • Individual + Spouse + Children: $112.61
  • Individual over 65: $39.97

BlueCare DentalPlus Benefit Details and Exclusions

Dental:

  • $1,500 annual maximum
  • 12 month waiting period on major services
  • $50 annual deductible per Insured (combined deductible applies to Primary and Major services)
  • 100% for preventive services (Accumulates to annual maximum)
  • Major services with 50/50 coinsurance (Accumulates to annual maximum)
  • Primary services with 80/20 coinsurance (Accumulates to annual maximum)
  • $200 annual maximum for whitening services and supplies provided by dentist (100% accumulates to annual maximum)


These Preventive Services are covered at 100 percent of the allowable charge (accumulates to annual $1,500 maximum):

  • Oral examinations
  • Prophylaxis, including cleaning, scaling and polishing 
  • Dental x-rays required to treat or diagnose diseases or abnormalities of the teeth, surrounding tissue and cavity detection

 

These Primary Services benefits are covered at 80 percent of the allowable charge, following a $50 annual deductible (combined deductible applies to Primary and Major services), to an annual maximum benefit payment of $1,500 each calendar year:

  • Simple extractions
  • Fillings (except gold)
  • Root canal treatment
  • Endodontics
  • Periodontic treatment of the gums, consisting of examination, management and surgery
  • Extraction of impacted teeth
  • Inlays
  • Repair of dentures
  • General anesthesia when the dental treatment is a covered service
  • Emergency treatment to temporarily relieve acute dental pain (subject to limitations)
  • Non-surgical care of acute oral infection and oral lesions

 

These Major Services benefits are covered at 50 percent of the allowable charge, following a $50 annual deductible (combined deductible applies to Primary and Major services), to an annual maximum benefit payment of $1,500 each calendar year:

  • Crowns
  • Onlays
  • Dentures
  • Bridges
  • Oral/Periodontal Surgery (Other than Periodontal surgery of the gums)
  • Dental Implants

 

Dental plan services NOT covered:

  • Any dental service not listed as a covered service in this program
  • Patient education services, hospital calls and/or consultations
  • Laboratory and pathological examinations
  • Bone grafts for alveolar ridge augmentation
  • Dental services primarily for cosmetic purposes, except for an accidental injury
  • All Temporomandibular Joint Dysfunction Syndrome related services, occlusal adjustments
  • Temporary or provisional dental services and procedures
  • Orthodontic services
Refer to the policy for a more complete list of exclusions and limitations. With this optional dental program, you will need to use a Blue Cross and Blue Shield of Kansas contracting dentist to receive maximum benefits.


You may complete the enrollment form, and either fax it to 785-290-0770 or mail it to:

Blue Cross and Blue Shield of Kansas
PO Box 239
Topeka KS 66601-9834

We're here for you

  • Phone: Learn more about the individual dental plans by calling 291-4306 in Topeka or toll-free at 1-800-641-1019.
  • Email: If you have any questions or would like information on this program, contact us at IndFamilyRep@bcbsks.com.