Value Certified

Blue Dental Value Certified offers maximum savings for individuals and families.

Value Certified

PLAN

=

Advantage Plus

NETWORK

One out of three dollar signs for cost and two umbrellas out of three for coverage
Here are some plan features and benefits:
  • Coverage for major services for adults is not included
  • Adult annual benefit maximum of $500
  • $0 annual deductible per member; $50 annual deductible per child
  • No out-of-pocket costs and no deductible for preventive dental care – exams and cleanings
  • Coverage for simple extractions and fillings
  • Pediatric dental coverage and coverage for medically necessary orthodontia for children up to age 21
  • Coverage for adults age 21 and over
  • Coverage for in- and out-of-network services

Value Certified

Benefits
Deductible (per adult member each year)1 $0
Deductible (per member under 21 per calendar year)1 $50
Adult benefit maximum per year - members age 21 and older $500
Child benefit maximum per year - members under age 21 Unlimited
Child out-of-pocket yearly maximum - members under age 21

$350 for 1 Child

$700 for 2 or more Children

Child2 No Waiting Period Adult Adult Waiting Period
Routine Oral Exams and Cleanings1 100% 100% None
Oral X-Rays1 100% 100% None
Fluoride Treatments1, Sealants1 100% Not Covered Not Covered
Palliative Treatment (Emergency)1 100% 100% None
Basic Restorative (Amalgam, Resin Fillings), Endodontics 80% 60% None
Oral Surgery, Surgical Extractions 80% 60% None
Simple Extractions 80% 60% None
Periodontics - Surgical and Non-Surgical 80% Not Covered Not Covered
Crown Repairs 80% Not Covered Not Covered
Crowns and Prosthetics (Bridges, Dentures) 50% Not Covered Not Covered
Implants - Must meet Dental Necessity Requirements 50% Not Covered Not Covered
Orthodontics (Members Under Age 21 Only)
Medically Necessary 50% Not Covered Not Covered
1Does not apply to diagnostic and preventive services
2Members under age 21. Certain benefits are limited to children younger than 18.
See contract and schedule of benefits for coverage exclusions and limitations
To take full advantage of your Blue Dental coverage, choose a dentist who participates in the Advantage Plus network.* Dentists in the Advantage Plus network provide covered services at a significant savings.
 
*Advantage Plus Network is administered by United Concordia Companies, Inc. United Concordia is an independent company that administers dental benefits on behalf of Blue Cross and Blue Shield of Louisiana.

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