Have Dental Blue Select?
Check your member ID card for the name of your dental plan. You'll find it listed on the top right and lower left corners of the card.
Dental claims forms
Filing appeals and grievances
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Dental Blue® for Individuals℠ plans
This preventive plan covers preventive services and offers savings on basic and major services.
Value 1500 PPO
This value plan covers preventive, basic and major services with richer benefits in-network.
This core plan covers preventive, basic and major services with the same benefit level in-network and out-of-network.
Frequently asked questions
Orthodontia service is an optional benefit which your employer can choose to include in coverage. Please contact your Group Administrator or refer to your Benefit Booklet to determine if Orthodontia is part of your plan.
No, there is no annual deductible. Dental Blue Select features a $100 lifetime deductible that applies to all services (diagnostic and preventive, basic and major services), except orthodontia services. Orthodontia services do not have a deductible.
Yes, Blue Cross NC may waive or reduce any applicable dental waiting period by the number of months of prior dental coverage. Proof of prior dental coverage with less than 63 days lapse in coverage is required.
You must have had full coverage for preventive, basic and major services. Preventive only, Discount Only or Dental Savings Plans do not count as full coverage for prior credit. The DBFI PPO Preventive plan offers a benefit for preventive, basic and major services, therefore members who enroll in the DBFI PPO Preventive plan will earn coverage credit.
Limitations and exclusions
This is a partial list of services that are not covered by Dental Blue for Individuals PPO, Dental Blue for Individuals PPO 1500 or Dental Blue for Individuals. Refer to the member booklet for a full list of exclusions. Your coverage may be canceled by Blue Cross NC for failure to pay premiums when due and for fraudulent statements on your application, among other reasons. Members will be notified 30 days in advance of any change in coverage. Consult your member guide for complete information. Your dental benefits plan does not cover services, supplies, drugs or charges that are:
- Orthodontic services
- Not clinically necessary
- Investigational in nature or obsolete, including any service, drugs, procedure or treatment directly related to an investigational treatment
- Not prescribed or performed by or under the direction of a dentist or other provider
- Received prior to the member’s effective date
- Received on or after the coverage termination date, regardless of when the treated condition occurred or whether the care is a continuation of care received prior to the termination
- For failure to keep a scheduled visit, completion of a claim form, obtaining dental records and late payments
- Incurred more than 18 months prior to member’s submission of a claim to Blue Cross NC
- For complications or side effects arising from services, procedures or treatments excluded from coverage under this dental benefits plan
- Provided and billed by a licensed dental care professional who is in training
- Available to a member without charge
- For care given to a member by a provider who is in the member’s immediate family
- In excess of the allowed amount
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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