Information for members with individual or family dental plan
Deductibles, coinsurance and “roll overs”
- In most cases, members are responsible for deductibles and coinsurance at the time services are performed.
- If you met your deductible on another dental plan, you cannot receive credit toward this plan’s deductible.
- With Gold or Gold Plus Vision, you may "roll over" a portion of your unused maximum benefit to the next year ($350) if you submit at least one claim during the year and your total claims do not exceed $500 for the year.
Dependent coverage
- Stepchildren are eligible for coverage.
- Single, dependent children are covered to age 26 as long as premiums are paid when due.
Payment of premium
- Members have a "grace period" of 31 days to pay a premium after it is due. However, if the payment is not received, the policy will be terminated on the date the premium was due.
- For members who enrolled through the Health Insurance Marketplace and applied a portion of their Advance Premium Tax Credits (APTC) toward the payment of their premium, a grace period of three consecutive months will be granted for the payment of premiums after receipt of the first month’s premium.
- If your policy cancels for non-payment of premium, it may be reinstated within 60 days if the premium is paid (certain rules may apply). To get your policy reinstated and pay your premium, call 800-238-8379. (Reinstatement policy does not apply to policies purchased through the Health Insurance Marketplace.)
Waiting periods
- Pediatric Minor and Major Restorative Services are not subject to waiting periods.
- Adult members enrolled in Dental Silver will have the 6-month waiting period for Minor Restorative services. The waiting period will be waived if the follow criteria is met:
- The application is received within 30 days of the termination date of the member’s previous coverage; and
- No later than 60 days from the effective date of the new policy with Arkansas Blue Cross and Blue Shield, the member provides us with:
- A copy of the member’s previous dental policy Certificate of Coverage which reflects the policy's effective and termination dates; and
- A copy of the member’s previous policy's benefit schedule which reflects at least six months of coverage for Minor Restorative services.
- Members enrolled in Dental Gold or Gold Plus Vision will have the 6-month waiting period for Minor and Major Restorative services waived if the follow criteria is met:
- The application is received within 30 days of the termination date of the member’s previous coverage; and
- No later than 60 days from the effective date of the new policy with Arkansas Blue Cross and Blue Shield, the member provides us with:
- A copy of the member’s previous dental policy Certificate of Coverage which reflects the policy's effective and termination dates; and
- A copy of the member’s previous policy's benefit schedule which reflects at least six months of coverage for Minor and/or Major Restorative services.
Other things to know
Monthly premiums can automatically be deducted from your bank account. Call 800-238-8379 for more information.
Orthodontic services are not covered.
If you visit a nonparticipating dentist and need to have your claim processed, please mail your claim form to:
Dental Claims Administrator
P.O. Box 69436
Harrisburg, PA 17106-9436
Information for members with individual or family dental plan prior to 2014
DentalBlue Gold, Silver and Bronze Member
Deductibles, coinsurance and “roll overs”
- In most cases, members are responsible for deductibles and coinsurance at the time services are performed.
- If you met your deductible on another dental plan, you cannot receive credit toward this plan’s deductible.
- With DentalBlue Gold, you may "roll over" a portion of your unused maximum benefit to the next year ($350) if you submit at least one claim during the year and your total claims do not exceed $500 for the year.
Dependent coverage
- Stepchildren are eligible for coverage.
- Single, dependent children are covered to age 26 as long as premiums are paid when due. When a dependent turns age 26, he or she will be enrolled automatically in an individual dental plan of his or her own. A notice will be sent to you and your dependent.
Payment of premium
- Members have a "grace period" of 31 days to pay a premium after it is due. However, if the payment is not received, the policy will be terminated on the date the premiums were due.
- If your policy does get cancelled due to non-payment of premiums, it may be reinstated within 60 days if the premium is paid (certain rules may apply). To get your policy reinstated and pay your premium, call 800-238-8379.
Waiting periods
- If you had dental coverage with another insurance company and now you have either our Silver or Gold plans, the waiting period for minor restorative services can be waived if you submit proof of Minor Restorative Creditable Coverage. Your Certificate of Creditable Coverage needs to reflect minor restorative coverage.
- If you have applied for coverage under DentalBlue and your coverage has been in place for at least six months with BlueCare Dental, we will waive the six-month minor restorative waiting period.
- Although you have had prior dental coverage, the waiting period for major restorative services under the Gold plan cannot be waived.
Other things to know
- Monthly premiums can automatically be deducted from your bank account. Call 800-238-8379 for more information.
- Orthodontic services are not covered.
- If you visit a nonparticipating dentist and need to have your claim processed, please mail your claim form to:
Dental Claims Administrator
P.O. Box 69436
Harrisburg, PA 17106-9436
BlueCare Dental Members
Deductibles, coinsurance and roll overs
- In most cases, members are responsible for deductibles and coinsurance at the time services are performed.
- BlueCare Dental does not allow members to "roll over" any unused benefits for use in the next calendar year.
- If you met your deductible on another dental plan, you cannot receive credit toward this plan’s deductible.
Dependent coverage
- Stepchildren are eligible for coverage.
- Single, dependent children are covered through age 18 as long as premiums are paid when due. When a dependent turns age 19, he or she will be enrolled automatically in an individual dental plan of his or her own. A notice will be sent to you and your dependent.
Payment of premium
- Members have a "grace period" of 31 days to pay a premium after it is due. However, if the payment is not received, the policy will be terminated on the date the premiums were due.
- If your policy does get cancelled due to non-payment of premiums, it may be reinstated within 60 days if the premium is paid (certain rules may apply). To get your policy reinstated and pay your premium, call 800-238-8379.
Waiting periods
If you had dental coverage with another insurance company, it does not count toward offsetting the waiting periods or deductibles with BlueCare Dental.
Other things to know
- New enrollments for this product are no longer being accepted after Jan. 1, 2011. However, new affordable plans are available.
- Orthodontic services are not covered.
- If you visit a nonparticipating dentist and need to have your claim processed, please mail your claim form to:
Dental Claims Administrator
P.O. Box 69436
Harrisburg, PA 17106-9436