Individual Select Preferred
PPO Dental Plan
Starting at $12.62 per Month Payable Annualy
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: |
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 |
|
|
Dental Service |
Regular Cost of Dental Services* |
Individual Select Dental HMO You Pay |
|
Biannual Checkups (twice a year) including routine exams, cleanings and x-rays |
$225 (2 visits per year) |
$20 per office visit copay |
|
Simple Tooth Extractions |
$135 |
$20 per office visit copay |
|
Periodontal Scaling and Root Planing (four or more teeth per section of the mouth) |
$210 |
$70 per office visit copay |
|
Porcelain Crown (high noble metal) |
$915 |
$460 |
|
Complete Upper Dentures |
$1,375 each |
$495 each |
|
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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