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Find the dental insurance plan that's right for you
No matter which plan you choose, we'll cover your preventive care. Every plan includes 2 checkups and cleanings per benefit period, no deductible for preventive care services, and a large network of dental providers.
- Under 65
- 65 or older
Under 65
| Preventive PPO | Value 1500 | Core 1000 | |
|---|---|---|---|
| Overview | Covers preventive services and offers savings on basic and major services with better benefits for in-network services. | Covers preventive, basic and major services with better benefits for in-network services. | Covers preventive, basic and major services with the same benefit level whether you see an in-network or out-of-network dentist. |
| Cost per member, per month | $23.861 | $35.951 | $37.451 |
| In-network deductible, basic and major services | $0 | $50 | $75 |
| Out-of-network deductible, basic and major services | $250 | $100 | $75 |
| Annual maximum | $5,0002 | $1,5003 | $1,0003 |
| Preventive services in-network | 0%4 | 0%4 | 0%4 |
| Preventive services out-of-network | 10% coinsurance4 | 30% of the allowed amount4 | |
| Basic services in-network | Up to 70% of the total bill | 20% coinsurance | 30% coinsurance |
| Major services in-network | Up to 70% of the total bill | 50% coinsurance | 50% coinsurance |
| Major services out-of-network | 95% of the provider's allowed amount4 | 50% coinsurance4 | 50% coinsurance5 |
| Preventive services waiting period | No waiting period6 | No waiting period | No waiting period |
| Basic services waiting period | No waiting period6 | 6 months | 6 months |
| Major services waiting period | No waiting period6 | 12 months6 | 12 months6 |
65 or older
| Preventive PPO | Value 1500 | Core 1000 | |
|---|---|---|---|
| Overview | Covers preventive services and offers savings on basic and major services with better benefits for in-network services. | Covers preventive, basic and major services with better benefits for in-network services. | Covers preventive, basic and major services with the same benefit level whether you see an in-network or out-of-network dentist. |
| Cost per member, per month | $23.861 | $44.351 | $45.851 |
| In-network deductible, basic and major services | $0 | $50 | $75 |
| Out-of-network deductible, basic and major services | $250 | $100 | $75 |
| Annual maximum | $5,0002 | $1,5003 | $1,0003 |
| Preventive services in-network | 0%4 | 0%4 | 0%4 |
| Preventive services out-of-network | 10% coinsurance4 | 30% of the allowed amount4 | 0%4 |
| Basic services in-network | Up to 70% of the total bill | 20% coinsurance | 30% coinsurance |
| Major services in-network | Up to 70% of the total bill | 50% coinsurance | 50% coinsurance |
| Major services out-of-network | 95% of the provider's allowed amount4 | 50% coinsurance4 | 50% coinsurance4 |
| Preventive services waiting period | No waiting period6 | No waiting period | No waiting period |
| Basic services waiting period | No waiting period6 | 6 months | 6 months |
| Major services waiting period | No waiting period6 | 12 months6 | 12 months6 |
You can buy a dental insurance plan even if you don't have a Blue Cross NC health insurance plan. Family members can use the same plan or choose different plans.
Each Blue Cross and Blue Shield of North Carolina (Blue Cross NC) member is billed separately and will receive their own member ID card.
Rates shown expire 12/31/2024.
Why stay in-network for your dental care?
Seeing a Blue Cross NC provider will lead you to the most savings for your dental care.
Out-of-network providers may bill you more than the allowed amount, which means higher costs for you and your family.
What's covered in our dental insurance plans
These may include:
- Fluoride treatment
- Oral exams
- Routine cleanings
- Routine X-rays
- Sealants
- Other diagnostic and preventive services
Check your Benefit Booklet for a full list of services covered under your plan.
These may include:
- Fillings
- Simple extractions
- Stainless steal crowns
Check your Benefit Booklet for a full list of services covered under your plan.
These may include:
- Bridges
- Dentures
- Endodontics
- Inlays / onlays
- Periodontal maintenance
- Porcelain crowns
- Oral surgery
Check your Benefit Booklet for a full list of services covered under your plan.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides free aids to service people with disabilities as well as free language services for people whose primary language is not English. Please contact 888-206-4697 (TTY: 711) for assistance.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) proporciona asistencia gratuita a las personas con discapacidades, así como servicios lingüísticos gratuitos para las personas cuyo idioma principal no es el inglés. Llame al 888-206-4697 (TTY: 711) para obtener ayuda.
Dental Blue for Individuals is not part of the covered health insurance benefits of any Blue Cross NC plans. Dental Blue for Individuals must be purchased separately.
Your dental benefit plan does not cover services, supplies, drugs or charges that are:
- Not clinically necessary
- Hospitalization for any dental procedure
- Dental procedures performed solely for cosmetic or aesthetic reasons, except when dental procedures are performed in order to restore normal function to minor children with congenital defects and anomalies
- Dental procedure not directly associated with dental disease
- Procedures not performed in a dental setting
- Procedures that are considered to be experimental, including pharmacological regimens not accepted by the American Dental Association (ADA) Council on Dental Therapeutics
- Placement of dental implants, implant-supported abutments and prostheses. This includes pharmacological regimens and restorative materials
- Drugs or medications, obtainable with or without a prescription, unless they are dispensed and utilized in the dental office during the patient visit
- Setting of facial bony fractures and any treatment associated with the dislocation of facial skeletal hard tissue
- Treatment of malignant or benign neoplasm's, cysts, or other pathology, except excisional removal. Treatment of congenital malformations of hard or soft tissue, excluding excision. Hard or soft tissue biopsies of neoplasm's, cysts, or soft tissue growths of unknown cellular make-up are not excluded
- Replacement of complete or partial dentures, fixed bridgework, or crowns within 8 years of initial or supplemental placement. This includes retainers, habit appliances, and any fixed or removable interceptive orthodontic appliances
- Services related to the temporomandibular joint (TMJ), either bilateral or unilateral
- Expenses for dental procedures begun prior to the member’s eligibility with Blue Cross NC
- Fixed or removable prosthodontic restoration procedures for complete oral rehabilitation or reconstruction
- Attachments to conventional removable prostheses or fixed bridgework, including semi-precision or precision attachments associated with partial dentures, crown or bridge abutments, full or partial over dentures, any internal attachment associated with an implant prosthesis, and any elective endocentric procedure related to a tooth or root involved in the construction of a prosthesis of this nature
- Procedures related to the reconstruction of a patient’s correct vertical dimension of occlusion (VDO)
- Denture relines for complete or partial conventional dentures are not covered for six months following the insertion of a prosthesis. Tissue conditioning and soft and hard relines for immediate full and partial dentures are not covered for six months after insertion of the full or partial denture. After this specified period, relines are covered once every 12 months.
- One hard tissue periodontal surgery and one soft tissue periodontal surgery per surgical area are covered within a three-year period. This includes gingivectomy, gingivoplasty, gingival curettage (with or without a flap procedure), osseous surgery, pedicel grafts, and free soft tissue grafts
- Osseous grafts, with or without resorbable or non-resorbable GTR membrane placement, are covered once every 36 months per quadrant or surgical site
- Clinical situations that can be effectively treated by a more cost-effective, clinically acceptable alternative procedure will be assigned a benefit based on the less costly procedure
- Services for incision and drainage if the involved abscessed tooth is removed on the same date of service
- Full mouth debridement is limited to once every 5 years
- Occlusal guards for any purpose other than control of habitual grinding
- Placement of fixed bridgework solely for the purpose of achieving periodontal stability
- Orthodontic services
Waiting periods can be reduced by the number of months of prior full dental coverage.
Disclosures:
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides free aids to service people with disabilities as well as free language services for people whose primary language is not English. Please contact 888-206-4697 (TTY: 711) for assistance.
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Rates may change.
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Benefits payable under basic and major services for this plan are limited, and you will pay most of the cost. Benefit plan maximum $5,000 includes preventive services, as well as any plan payments toward basic and major, if applicable.
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Amounts that Blue Cross NC pays for preventive, basic and major services apply to the annual maximum.
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What we pay out-of-network providers is an "allowed amount," which is based on an average of our in-network contracted rates with participating providers. An allowed amount may be less than the provider's actual charge. You are responsible for charges above the allowed amount, in addition to any deductible and coinsurance applied.
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While you pay the same percentage for in- and out-of-network services with Core 1000, you may owe on costs above the allowed amount out-of-network.
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Waiting periods can be reduced by the number of months of prior full dental coverage.
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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