With the BCBSIL dental plans, you’ll get dental coverage on day one with no deductibles required for check-ups, cleanings and other preventive services. Most important, costs are typically reduced when you receive care from any of our participating network dentists. However, you also have the option to see any dentist not in the network, but your out-of-pocket costs may be higher.
Or download a paper application.
Be advised, you can only sign up for BCBSIL dental during open enrollment (Nov 1-Dec 15) or if you qualify for a special enrollment period and are signing up for a health plan.
If you're looking for an alternative, we would suggest a plan from Ameritas dental that has increased benefits and competitive pricing.
With BlueCare® Dental PPO 1A, you’ll get:
- One of the highest maximum annual benefit levels available – up to $1,500 per person per year
- Orthodontic services covered up to age 19
- No annual maximum on BlueCare Dental 4 Kids 1A
| BlueCare Dental 1A | BlueCare Dental 4 Kids 1A | BlueCare Dental 1B | BlueCare Dental 4 Kids 1B | |||||
|---|---|---|---|---|---|---|---|---|
| Benefit Summary | Benefit Summary | Benefit Summary | Benefit Summary | |||||
| In Network | Out of Network | In Network | Out of Network | In Network | Out of Network | In Network | Out of Network | |
| Deductible (family x3) | $50 | $50 | $50 | $50 | $75 | $75 | $75 | $75 |
| Annual Maximum | $15002 | N/A | $10002 | N/A | ||||
| Diagnostic Evaluations | 100%3 | 70%3 | 100%3 | 70%3 | 90%3 | 70%3 | 80%3 | 60%3 |
| Preventive | 100%3 | 70%3 | 100%3 | 70%3 | 90%3 | 70%3 | 80%3 | 60%3 |
| Diagnostic Radiographs | 100%3 | 70%3 | 100%3 | 70%3 | 90% | 70% | 80% | 60% |
| Misc. Preventive Services | 80% | 50% | 80% | 50% | 70% | 50% | 80% | 60% |
| Basic Restorative | 80% | 50% | 80% | 50% | 70% | 50% | 50% | 30% |
| Non-Surgical Extractions | 80% | 50% | 80% | 50% | 70% | 50% | 50% | 30% |
| Non-Surgical Periodontal | 80% | 50% | 80% | 50% | 70% | 50% | 50% | 30% |
| Adjunctive Services | 80% | 50% | 80% | 50% | 70% | 50% | 50% | 30% |
| Endodontics (root canal) | 80% | 50% | 80% | 50% | 70% | 50% | 50% | 30% |
| Oral Surgery | 80% | 50% | 80% | 50% | 50% | 30% | 50% | 30% |
| Surgical Periodontal | 80% | 50% | 80% | 50% | 50% | 30% | 50% | 30% |
| Major Restorative | 50% | 30% | 50% | 30% | 50% | 30% | 50% | 30% |
| Prosthodontics | 50% | 30% | 50% | 30% | 50% | 30% | 50% | 30% |
| Misc Restorative & Prosthodontics Services | 50% | 30% | 50% | 30% | 50% | 30% | 50% | 30% |
| Orthodontics (up to age 19) | 50% | 30% | 50% | 30% | 50% | 30% | 50% | 30% |
| Out of Pocket Maximum7 | $350 for one child / $700 for 2+ children | $350 for one child / $700 for 2+ children | $350 for one child / $700 for 2+ children | $350 for one child / $700 for 2+ children | ||||
| Rates | ||||||||
| Region 1 | Region 2 | Region 1 | Region 2 | Region 1 | Region 2 | Region 1 | Region 2 | |
| Primary Applicant | $38.475 | $31.315 | $34.825 | $28.345 | $28.535 | $23.235 | $26.625 | $21.665 |
| Member + Spouse | $76.945 | $62.625 | N/A5 | N/A5 | $55.405 | $46.465 | N/A5 | N/A5 |
| Member + 1 Child | $73.295 | $59.655 | N/A5 | N/A5 | $58.70 | $44.895 | N/A5 | N/A5 |
| Family | $181.40 | $147.645 | N/A5 | N/A5 | $148.405 | $111.445 | N/A5 | N/A5 |
- This document does not contain a complete listing of the exclusion, limitations and conditions that apply to the benefits shown. For full information refer to the member’s certificate of benefits booklet.
- Annual maximum does not apply to members up to under 19.
- Deductible is waived.
- Rates are subject to change.
- Region 1 rates apply to members residing in the following counties: Cook, DuPage, Kane, Lake, and McHenry
- Region 2 rates apply to all members residing in counties outside Region 1
- Out of Pocket Maximum only applies to members under 19.
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