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 2013:
- Individuals under age 65 may enroll during January, February, May and June.
- Those over age 65 may enroll during March, April, July and August.
- Individual under 65: $26.39
- Individual + Children: $59.67
- Individual + Spouse: $64.66
- Individual + Spouse + Children: $93.67
- Individual over 65: $27.19
These benefits are covered at 100 percent of the allowable charge:
- Oral examinations - two per year
- Prophylaxis, including cleaning, scaling and polishing - two per year
- Dental x-rays required to treat or diagnose diseases or abnormalities of the teeth, surrounding tissue and cavity detection (limited to two bitewing x-rays per year and one full mouth x-ray during a five-year period)
These benefits are covered at 80 percent of the allowable charge, following a $50 annual deductible, to an annual maximum benefit payment of $1,000 each calendar year:
- Simple extractions
- Fillings (except gold)
- Root canal treatment
- Periodontic treatment of the gums, consisting of examination, management and surgery
- Extraction of impacted teeth
- Repair of dentures
- General anesthesia when the dental treatment is a covered service
Dental plan services NOT covered:
- Any dental service or procedure relating to the teeth, gums or structures supporting the teeth or providing for proper occlusion of the teeth not listed in this dental care program.
- Patient education services; hospital calls and consultations.
- Laboratory and pathological examinations; occlusal adjustments.
- Dental implant services.
- Services for diseases or injuries caused by or arising out of acts of war or aggression.
- Services for cosmetic purposes if over age 21, except for an accidental injury.
- Services related to alveolar ridge augmentations.
- Temporomandibular joint dysfunction syndrome services.
- Orthodontic services.
- Crowns, onlays and oral surgery.
- Dentures (full or partial) and bridges (fixed or removable).
Please note: 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 785-290-0716 or mail it to:
Blue Cross and Blue Shield of Kansas
PO Box 517
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.
- E-mail: If you have any questions or would like information on this program, contact us at IndFamilyRep@bcbsks.com.