Under 65    Over 65    Groups 1-9    Groups 10-99    Groups 100+    Other Plans

Plan 65 - Dental

This optional program is only available to you at the time you enroll in your health program. Coverage may not be added at a later date.

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

 

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.

- Back -