2020 Pediatric & Adult/Family Dental Plans
BlueCross BlueShield of Western New York offers stand-alone pediatric and adult dental plans for small groups. Our plans provide essential health benefits to ensure members receive comprehensive oral health coverage through our own dental network.
- Pediatric Dental is an Essential Health Benefit as outlined in the Affordable Care Act.
- Groups can choose one Blue Value dental plan to offer their employees in addition to Blue Pediatric dental.
- Blue Value dental plans include Blue Pediatric dental benefits and coverage for adults and adult dependents aged 19 to 26 years.
- Flexibility to see out-of-network dentists.
Note: Members can receive dental services from a provider who does not participate in the BlueCross BlueShield contracted network of providers. Out-of-network services are reimbursed at 100% of the in-network fee schedule and the nonparticipating provider may balance bill the member for the remainder.
* Blue Value Dental 3 includes coverage for children up to age 19 for medically necessary orthodontics subject to an out-of-pocket maximum (see Blue Pediatric Benefits) and cosmetic orthodontics (routine braces) subject to a lifetime maximum per member. Adults and adult dependents have coverage for cosmetic orthodontics (routine braces) subject to a lifetime maximum per member.
**Blue Pediatric dental benefits and cost-sharing are included in all Blue Value dental plans. Adults and adult dependents, ages 19–30, are covered in Blue Value Dental plans.
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2019 Pediatric & Adult Plans
2019 Pediatric & Adult/Family Dental Plans
BlueCross BlueShield of Western New York offers stand-alone pediatric and adult dental plans for small groups. Our plans provide essential health benefits to ensure members receive comprehensive oral health coverage through our own dental network.
- Pediatric Dental is an Essential Health Benefit as outlined in the Affordable Care Act.
- Groups can choose one Blue Value dental plan to offer their employees in addition to Blue Pediatric dental.
- Blue Value dental plans include Blue Pediatric dental benefits and coverage for adults and adult dependents aged 19 to 26 years.
- Flexibility to see out-of-network dentists.
Note: Members can receive dental services from a provider who does not participate in the BlueCross BlueShield contracted network of providers. Out-of-network services are reimbursed at 100% of the in-network fee schedule and the non-participating provider may balance bill the member for the remainder.
*Available on SHOP
**Blue Pediatric dental benefits and cost-sharing are included in all Blue Value dental plans. Pediatric Dental is an essential health benefit as outlined in the Affordable Care Act. As an insurer, we are required to make our best efforts to ensure that you obtain this coverage.
***Blue Value Dental 3 includes coverage for children up to age 19 for medically necessary orthodontics subject to an out-of-pocket maximum (see Blue Pediatric Benefits) and cosmetic orthodontics (routine braces) subject to a lifetime maximum per member. Adults and adult dependents have coverage for cosmetic orthodontics (routine braces) subject to a lifetime maximum per member.
