Dental Blue®

Dental Blue®

 

Your Dental Blue Freedom coverage consists of: a Dental Blue plan; and a Dental Blue PPO plan.

In-Network Benefits

Dental Blue provides benefits for covered dental services when they are furnished by a participating dentist, or a hygienist who is employed by the participating dentist, who has a written payment agreement with Blue Cross and Blue Shield, but not a PPO provider contract, to furnish covered dental services to members enrolled under a Dental Blue plan. The benefit level and cost-share amounts for covered dental services furnished by these Dental Blue participating dentists are described in the Benefits Payable Riders that are part of your Dental Blue Freedom Benefit Description. (These riders will tell you whether benefits for covered dental services that are furnished by a Blue Cross and Blue Shield participating dentist who is not a PPO dentist are provided as in-network benefits or out-of-network benefits under your Dental Blue Freedom option.)

For covered dental services that are furnished by a Blue Cross and Blue Shield participating dentist who also has a preferred provider payment agreement (a PPO provider contract) with Blue Cross and Blue Shield, your benefits for covered dental services furnished by that dentist are provided as described in Dental Blue PPO in-network benefits.

For covered dental services that are furnished by a dentist, or a hygienist who is employed by the dentist, who does not have a participating payment agreement with Blue Cross and Blue Shield, your benefits are provided as described in Dental Blue PPO.

For covered dental services that are furnished outside of Massachusetts, your benefits are provided as described in Dental Blue PPO.