Dental insurance 101

Dental Insurance 101

Blue KC offers comprehensive individual dental plans with attractive benefits. Not only are they designed to protect your smile, they're priced to make you smile.

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Dental Services

Preventive services are available from the effective date of coverage, but some services require a waiting period. These include basic restorative, major restorative, endodontics, periodontics and oral surgery needs like root canals, tooth extractions and preparation of the mouth for dentures and anesthesia (when used during a covered service).

RESTORATIVE

ENDODONTICS

PERIODONTICS

ORAL SURGERY

Network Options

BLUE DENTAL PPO

This network provides the lowest out-of-pocket costs for covered services, and is preferred in the Blue KC service area. Outside our service area, these are GRID providers.

BLUEDENTAL CHOICE

This additional network provides higher out-of-pocket costs for covered services. Outside our service area, these are GRID+ providers.

THE GRID/GRID+

The GRID/GRID+ network is for members who live, work or travel outside the Blue KC service area. These providers are Blue Cross and Blue Shield contracted dentists.

Dental Benefits

All BlueDental Plans cover in-network preventive dental services at 100% when you see a PPO provider. So, you don't pay anything out-of-pocket when visiting a PPO dentist for a semi-annual check up. Members pay a deductible and coinsurance for other services covered under the plan.

TYPE I
DENTAL SERVICES
(Preventive)
BlueDental 1000
BlueDental Plus 1000
BlueDental Plus 1200
BlueDental Plus 1500
Blue Dental Network PPO Choice PPO Choice PPO Choice PPO Choice
DEDUCTIBLE
(Per each covered person)
N/A N/A N/A N/A N/A N/A N/A N/A
DIAGNOSTICS AND PREVENTIVE SERVICES
2 oral exams per calendar year
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
Dental X-Rays
Complete Mouth
1 every three calendar years;
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
Single Tooth
12 per calendar year;
Bitewing
2 sets per calendar year;
Flouride Treatment
2 per calendar year for members age 19 and under
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
Teeth Cleaning
2 per calendar year
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
Sealants
One treatment per tooth in any 3 calendar
year period for members 14 and under
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
Fixed and Removable Space Maintainers
Initial appliance only
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
Emergency Palliative Treatment
(Pain relief)
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
TYPE II
DENTAL SERVICES
(Basic)*
BlueDental 1000
BlueDental Plus 1000
BlueDental Plus 1200
BlueDental Plus 1500
Blue Dental Network PPO Choice PPO Choice PPO Choice PPO Choice
DEDUCTIBLE
(Per each covered person)
$50 $50 $50 $50 $50 $50 $50 $50
Fillings
Other Restorative SERVICES
Recementation of existing crowns and bridge
Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 33% coinsurance
Endodontics
Root canals and pulpotomies
Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance
Tooth Extraction Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance
Anesthesia
Payable only if provided in connection with a covered service
Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance Covered at 100% 15% Coinsurance
TYPE III
DENTAL SERVICES
(Major)**
BlueDental 1000
BlueDental Plus 1000
BlueDental Plus 1200
BlueDental Plus 1500
Blue Dental Network PPO Choice PPO Choice PPO Choice PPO Choice
DEDUCTIBLE
(Per each covered person)
Not Covered Not Covered $200 $200 $150 $150 $150 $150
Periodontics
Gum / tissue and surgery
Not Covered Not Covered Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance
Major Restorative
Prosthodontics
Crowns, inlays, onlays, bridges and dentures
Not Covered Not Covered Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance
Maintenance of Prosthodontice
Adjust / repair dentures
Not Covered Not Covered Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance Deductible then 50% coinsurance
Calendar Year Maximum $1,000 $1,000 $1,000 $1,000 $1,200 $1,200 $1,500 $1,500
Child Rate (Per Month) $24 $24 $28 $28 $30 $30 $32 $32
Adult Rate (Per Month) $27 $27 $35 $35 $37 $37 $39 $39

Dental plans are available in Johnson and Wyandotte counties in Kansas and in the following Missouri counties: Andrew, Atchison, Bates, Benton, Buchanan, Caldwell, Carroll, Cass, Clay, Clinton, Daviess, DeKalb, Gentry, Grundy, Harrison, Henry, Holt, Jackson, Johnson, Lafayette, Livingston, Mercer, Nodaway, Pettis, Platte, Ray, Saline, St. Clair, Vernon and Worth.

  • *Requires a six-month waiting period from your effective date.
  • **Requires a twelve-month waiting period from your effective date.
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Blue Cross and Blue Shield of Kansas City
One Pershing Square
2301 Main
Kansas City, MO 64108

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8530 Northwest Prairie View Road
Kansas City, MO 64153
816-395-2828

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15 On the Mall
Prairie Village, KS 66208
816-395-3787

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