Plan Information


Dental Blue offers affordable PPO solutions to meet your dental needs – all designed to give you the power to choose. Whether you choose the Dental Blue Basic or Dental Blue Enhanced, you have the power to visit any dentist or specialist in the Dental Blue Network.

Dental Blue Enhanced

Even though some services are not covered as part of the dental plan, discounted fees for these services are available from in-network dentists.

Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. ®ANTHEM is a registered trademark. ®The Blue Cross name and symbol are registered marks of the Blue Cross Association.

  In-network Out-of-network
Annual Deductible $50 per member/$150 maximum per family
Waived for Diagnostic and Preventive Yes No
Annual Maximum $1250
Diagnostic and Preventive Services
Cleanings, exams and X-rays 100% 80%
Basic Services
Fillings 80% 60%
Other Minor Restorative 80% 60%
Major Services
Oral Surgery 50%
Endodontics 50%
Periodontics 50%
Prosthodontics 50%
Orthodontics Children only 50%, $100 deductible,
$500 annual/$1,000 lifetime maximum
Waiting Periods No waiting period for cleanings, exams and x-rays; six-month waiting period for basic services; 12 months for major services/orthodontics
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