Washington DC Blue Cross Blue Shield Dental Insurance Plans for Individuals
- Easy enrollment - No deductibles - Predictable out-of-pocket costs - No claims forms to file - Guaranteed acceptance
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Individual Select Preferred
| Beginning on October 1, 2011, all participating dentists, dental specialists, and oral surgeons in your Individual Select Preferred dental plan will no longer be required to accept the allowed amount (discount) as payment in full for non-preventive services. Examples of these services include fillings, extractions, root canals, crowns, and orthodontics. You should check with your participating dentist to determine whether (s)he will continue to honor the allowed amount (discount) for non-preventive services. Please note that this change does not impact covered services such as exams, cleanings and X-rays, which will continue to be paid at 100% when you use an in-network provider. For more details about covered services, please refer to the booklet you received with your dental identification card, titled “Dental Plan Benefit Information” for your Individual Select Preferred dental plan. Should you have additional questions about the content of this letter, please call Dental Business Operations Member Services at (888) 833-8464 between 8:30 a.m. – 5:00 p.m., Monday through Friday. |
CareFirst BlueCross BlueShield brings you
Individual Select Preferred Dental which offers:
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Individual Select Dental HMO
HMO Dental Plan
Starting at $10.00 per Month Payable Annualy
The Dental Network brings you the Individual Select Dental HMO Plan which offers: |
| Coverage Type |
Annual Rate |
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Full Annual Payment Due with Enrollment Application |
| Individual |
$151.44 |
| Individual & Child(ren) |
$280.20 |
| Individual & Adult |
$302.88 |
| Family |
$424.08 |
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See More Payment Options
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| Coverage Type |
Annual Rate |
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Full Annual Payment Due with Enrollment Application |
| Individual |
$120.00 |
| Individual & Child |
$204.00 |
| Individual & Adult |
$240.00 |
| Family |
$360.00 |
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See Other Payment Options
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Benefits at a Glance
- More than 3,400 dentists throughout Maryland, DC
and Northern Virginia |
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Dental Service |
Regular Cost of Dental Services* |
Individual Select Preferred You Pay |
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Biannual Checkups (twice a year) including routine exams, cleanings and x-rays |
$225 (2 visits per year) |
No charge in-network |
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Simple Tooth Extractions |
$135 |
$69-$93** |
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Periodontal Scaling and Root Planing (four or more teeth per section of the mouth) |
$210 |
$116-$137** |
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Porcelain Crown (high noble metal) |
$915 |
$575-$680** |
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Complete Upper Dentures |
$1,375 each |
$665-$800** each |
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Orthodontics (braces)
Adolescents
Adults |
$4,890
$5,110 |
$2,900-$4,700**
$2,900-$4,700** |
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Please see the brochure for details of the benefits
* Based on 2006 National Dental Advisory Service Fee Report.
** This portion of the plan is not an insurance product. In-network providers typically charge reduced rates within these ranges. Member charges are based on CareFirst allowances with the participating providers. Since rates vary by provider, members should check with their participating dentist to determine the costs of specific procedures. Members must pay these reduced rates directly to the provider during the office visit.
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Benefits at a Glance
-Lower cost
- More than 800 dentists throughout Maryland, DC
and Northern Virginia |
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Dental Service |
Regular Cost of Dental Services* |
Individual Select Dental HMO You Pay |
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Biannual Checkups (twice a year) including routine exams, cleanings and x-rays |
$225 (2 visits per year) |
$20 per office visit copay |
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Simple Tooth Extractions |
$135 |
$20 per office visit copay |
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Periodontal Scaling and Root Planing (four or more teeth per section of the mouth) |
$210 |
$70 per office visit copay |
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Porcelain Crown (high noble metal) |
$915 |
$460 |
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Complete Upper Dentures |
$1,375 each |
$495 each |
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Orthodontics (braces)
Adolescents
Adults |
$4,890
$5,110 |
$2,500
$2,700 |
Please see the brochure for details of the benefits
* Based on 2006 National Dental Advisory Service Fee Report.
** This portion of the plan is not an insurance product. In-network providers typically charge reduced rates within these ranges. Member charges are based on CareFirst allowances with the participating providers. Since rates vary by provider, members should check with their participating dentist to determine the costs of specific procedures. Members must pay these reduced rates directly to the provider during the office visit.
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Washington DC CareFirst Blue Cross Blue Shield Individual and Family Dental Insurance Plan APPLICATION INSTRUCTIONS |
CareFirst Blue Cross Blue Shield is not currently processing online applications for these products - To apply you MUST:
- Download and Print the application form ( Either PPOor HMO )
- Fill the form and mail it to the address specified on the form
- Be sure to include the full payment in check or money order
-Once your application has been received and processed, your benefits will begin on the First Day of the following month.
-If you have submitted your application and you have allowed 10 business days for processing and have not yet received your card. Please make sure that your check has cleared then call (888) 833-8464 |
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