What Is High Option Blue Cross Blue Shield
What's New in 2022
Here are some of the new ways we're supporting your smile in 2022:
Standard Option Changes
- We now provide in-network benefits for Class A, Class B, and Class C services at 100% for children age 13 and under.
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Download the full brochure here:
What's New FAQ
What's changing?
New for 2022 with Standard Option now classes A,B,C are covered at 100% for children age 13 and under when visiting an in-network provider.
Do I need to do anything?
No. No action is needed on your part if you're happy with your coverage. It will automatically roll over.
Will I have access to the same network of providers?
Yes. In fact, your network may have expanded. You can search for providers in our network at bcbsfepdental.com/findadentist.
Will I receive a new member ID card?
No. Current members can continue to use their existing member ID card.
Has the customer service number changed?
No. The number has not changed. You may call BCBS FEP Dental at 1-855-504-BLUE (2583). You can also find this number on the back of your member ID card.
Understanding Your Dental Benefits
Understanding your�Blue Cross Blue Shield�FEP Dental coverage is the key to making the most of your benefits, keeping your smile healthy and protecting your overall health.
Need help understanding and choosing a benefit plan? Our AskBlueSM BCBS FEP Dental Plan Finder tool can help you select the right plan for your needs.
We want you to be informed so that you can get the most appropriate and cost-effective care. Check out our Member Education Materials to get more information about�Blue Cross Blue Shield�FEP Dental's value and offerings.
| High Option | High Option | Standard Option | ||||
|---|---|---|---|---|---|---|
| You pay | ||||||
| IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK | OUT-OF-NETWORK | |||
| Class A (Basic) Services e.g., exams, cleanings, X-rays, sealants | Nothing | 10% | Nothing | 40% | ||
| Class B (Intermediate) Services e.g., oral surgery, fillings, gum scaling | 30% | 40% | 45% | 60% | ||
| Class C (Major) Services e.g., crowns, bridges, implants, root canals, dentures | 50% | 60% | 65% | 80% | ||
| Annual Deductible for Class A, B and C Services Does not apply to Class D (Orthodontics) | $0 | $50 per person | $0 | $75 per person | ||
| Class D (Orthodontics) Services Adults & Children | 50% up to $3,500 lifetime maximum per person | 50% up to $3,500 lifetime maximum per person | 50% up to $2,500 lifetime maximum per person | 50% up to $1,250 lifetime maximum per person | ||
| Annual Maximum Benefits for Class A, B and C Services Does not apply to Class D (Orthodontics) | Unlimited maximum per person | We pay $3,000 per person | We pay $1,500 per person | We pay $750 per person | ||
| Standard Option | ||
|---|---|---|
| You pay | ||
| IN-NETWORK | OUT-OF-NETWORK | |
| Class A (Basic) Services e.g., exams, cleanings, X-rays, sealants | Nothing | 40% |
| Class B (Intermediate) Services e.g., oral surgery, fillings, gum scaling | 45% | 60% |
| Class C (Major) Services e.g., crowns, bridges, implants, root canals, dentures | 65% | 80% |
| Annual Deductible for Class A, B and C Services Does not apply to Class D (Orthodontics) | $0 | $75 per person |
| Class D (Orthodontics) Services Adults & Children | 50% up to $2,500 lifetime maximum per person | 50% up to $1,250 lifetime maximum per person |
| Annual Maximum Benefits for Class A, B and C Services Does not apply to Class D (Orthodontics) | We pay $1,500 per person | We pay $750 per person |
Understanding Your Dental Premium
We calculate our dental premiums based on your location (rating areas) and the plan option you select.
Use our Premium Finder to easily find your premium amount or take a look at the tables below to determine your premiums.
To find your premium, locate your state and/or zip code in the rating area table below and to identify your rating area.
| State | First 3 digits of your ZIP Code | Rating Area |
|---|---|---|
| AK | Entire State | 5 |
| AL | Entire state | 1 |
| AR | Entire state | 2 |
| AZ | 855, 859-860, 863-865 | 2 |
| AZ | 850-853 | 3 |
| AZ | Rest of state | 1 |
| CA | 900-908, 910-928, 930-931, 933-935 | 4 |
| CA | 900-908, 910-928, 930-931, 933-935 | 4 |
| CA | 939-952, 954, 956-959 | 5 |
| CA | 939-952, 954, 956-959 | 5 |
| CA | Rest of state | 2 |
| CO | Entire state | 4 |
| CT | 060-063 | 5 |
| CT | Rest of state | 4 |
| DC | Entire area | 3 |
| DE | Entire state | 2 |
| FL | 330-334, 349 | 2 |
| FL | 330-334, 349 | 2 |
| FL | Rest of state | 1 |
| GA | Entire state | 1 |
| GU | Entire area | 1 |
| HI | Entire state | 3 |
| IA | 500-514, 516, 520-528 | 3 |
| IA | Rest of state | 2 |
| ID | Entire state | 4 |
| IL | 600-609, 613 | 2 |
| IL | 612 | 3 |
| IL | Rest of state | 1 |
| IN | 463-464 | 2 |
| IN | Rest of state | 1 |
| KS | 664-665, 667-679 | 2 |
| KS | Rest of state | 1 |
| KY | Entire state | 1 |
| LA | Entire state | 1 |
| MA | 010-011, 013-027, 055 | 5 |
| MA | Rest of state | 3 |
| MD | 205-212, 214, 216-217 | 3 |
| MD | Rest of state | 2 |
| ME | 039-042 | 5 |
| ME | Rest of state | 2 |
| MI | 480-485 | 2 |
| MI | Rest of state | 1 |
| MN | 550-551, 553-555, 563 | 4 |
| MN | Rest of state | 3 |
| MO | 726 | 2 |
| MO | Rest of state | 1 |
| MS | Entire state | 1 |
| MT | Entire state | 1 |
| NC | 270-274, 278, 280-282, 284-289 | 2 |
| NC | 275-277, 283 | 3 |
| NC | Rest of state | 1 |
| ND | Entire state | 5 |
| NE | Entire state | 2 |
| NH | 030-033, 038 | 5 |
| NH | Rest of state | 3 |
| NJ | 070-079, 085-089 | 4 |
| NJ | Rest of state | 2 |
| NM | Entire state | 1 |
| NV | 897 | 5 |
| NV | Rest of state | 2 |
| NY | 120-123, 128 | 3 |
| NY | 005, 100-119, 124-126 | 4 |
| NY | 063 | 5 |
| NY | Rest of state | 2 |
| OH | Entire state | 1 |
| OK | Entire state | 1 |
| OR | 970-973 | 4 |
| OR | Rest of state | 2 |
| PA | 189-196 | 2 |
| PA | 172-174 | 3 |
| PA | 180-181, 183 | 4 |
| PA | Rest of state | 1 |
| PR | Entire area | 1 |
| RI | Entire state | 5 |
| SC | Entire state | 2 |
| SD | Entire state | 1 |
| TN | Entire state | 1 |
| TX | Entire state | 1 |
| UT | Entire state | 2 |
| VA | 201, 205, 220-227 | 3 |
| VA | Rest of state | 1 |
| VI | Entire area | 1 |
| VT | Entire state | 5 |
| WA | 980-985 | 5 |
| WA | Rest of state | 4 |
| WI | 540 | 4 |
| WI | Rest of state | 3 |
| WV | 254 | 3 |
| WV | Rest of state | 1 |
| WY | 834 | 4 |
| WY | Rest of state | 2 |
| INTL | International | 1 |
| State | First 3 digits of your ZIP Code | Rating Area |
|---|---|---|
| KY | Entire state | 1 |
| LA | Entire state | 1 |
| MA | 010-011, 013-027, 055 | 5 |
| MA | Rest of state | 3 |
| MD | 205-212, 214, 216-217 | 3 |
| MD | Rest of state | 2 |
| ME | 039-042 | 5 |
| ME | Rest of state | 2 |
| MI | 480-485 | 2 |
| MI | Rest of state | 1 |
| MN | 550-551, 553-555, 563 | 4 |
| MN | Rest of state | 3 |
| MO | 726 | 2 |
| MO | Rest of state | 1 |
| MS | Entire state | 1 |
| MT | Entire state | 1 |
| NC | 270-274, 278, 280-282, 284-289 | 2 |
| NC | 275-277, 283 | 3 |
| NC | Rest of state | 1 |
| ND | Entire state | 5 |
| NE | Entire state | 2 |
| NH | 030-033, 038 | 5 |
| NH | Rest of state | 3 |
| NJ | 070-079, 085-089 | 4 |
| NJ | Rest of state | 2 |
| NM | Entire state | 1 |
| NV | 897 | 5 |
| NV | Rest of state | 2 |
| NY | 120-123, 128 | 3 |
| NY | 005, 100-119, 124-126 | 4 |
| NY | 063 | 5 |
| State | First 3 digits of your ZIP Code | Rating Area |
|---|---|---|
| NY | Rest of state | 2 |
| OH | Entire state | 1 |
| OK | Entire state | 1 |
| OR | 970-973 | 4 |
| OR | Rest of state | 2 |
| PA | 189-196 | 2 |
| PA | 172-174 | 3 |
| PA | 180-181, 183 | 4 |
| PA | Rest of state | 1 |
| PR | Entire area | 1 |
| RI | Entire state | 5 |
| SC | Entire state | 2 |
| SD | Entire state | 1 |
| TN | Entire state | 1 |
| TX | Entire state | 1 |
| UT | Entire state | 2 |
| VA | 201, 205, 220-227 | 3 |
| VA | Rest of state | 1 |
| VI | Entire area | 1 |
| VT | Entire state | 5 |
| WA | 980-985 | 5 |
| WA | Rest of state | 4 |
| WI | 540 | 4 |
| WI | Rest of state | 3 |
| WV | 254 | 3 |
| WV | Rest of state | 1 |
| WY | 834 | 4 |
| WY | Rest of state | 2 |
| INTL | International | 1 |
Once you have identified your rating area, you can view premium amounts for our available plans in the premium table below.
| High Option Premiums | ||||||
|---|---|---|---|---|---|---|
| Rating Area | Self Only | Self + One | Self & Family | |||
| BI-WEEKLY | MONTHLY | BI-WEEKLY | MONTHLY | BI-WEEKLY | MONTHLY | |
| 1/INTL | $18.05 | $39.11 | $36.11 | $78.24 | $54.16 | $117.35 |
| 2 | $20.22 | $43.81 | $40.44 | $87.62 | $60.66 | $131.43 |
| 3 | $22.01 | $47.69 | $44.03 | $95.40 | $66.04 | $143.09 |
| 4 | $23.84 | $51.65 | $47.68 | $103.31 | $71.52 | $154.96 |
| 5 | $26.68 | $57.81 | $53.35 | $115.59 | $80.03 | $173.40 |
| High Option Premiums | ||
|---|---|---|
| Rating Area | Self + One | |
| BI-WEEKLY | MONTHLY | |
| 1/INTL | $36.11 | $78.24 |
| 2 | $40.44 | $87.62 |
| 3 | $44.03 | $95.40 |
| 4 | $47.68 | $103.31 |
| 5 | $53.35 | $115.59 |
| High Option Premiums | ||
|---|---|---|
| Rating Area | Self & Family | |
| BI-WEEKLY | MONTHLY | |
| 1/INTL | $54.16 | $117.35 |
| 2 | $60.66 | $131.43 |
| 3 | $66.04 | $143.09 |
| 4 | $71.52 | $154.96 |
| 5 | $80.03 | $173.40 |
| Standard Option Premiums | ||||||
|---|---|---|---|---|---|---|
| Rating Area | Self Only | Self + One | Self & Family | |||
| BI-WEEKLY | MONTHLY | BI-WEEKLY | MONTHLY | BI-WEEKLY | MONTHLY | |
| 1/INTL | $9.22 | $19.98 | $18.44 | $39.95 | $27.67 | $59.95 |
| 2 | $10.10 | $21.88 | $20.21 | $43.79 | $30.31 | $65.67 |
| 3 | $11.48 | $24.87 | $22.95 | $49.73 | $34.40 | $74.53 |
| 4 | $12.39 | $26.85 | $24.76 | $53.65 | $37.12 | $80.43 |
| 5 | $13.68 | $29.64 | $27.37 | $59.30 | $41.05 | $88.94 |
| Standard Option Premiums | ||
|---|---|---|
| Rating Area | Self + One | |
| BI-WEEKLY | MONTHLY | |
| 1/INTL | $18.44 | $39.95 |
| 2 | $20.21 | $43.79 |
| 3 | $22.95 | $49.73 |
| 4 | $24.76 | $53.65 |
| 5 | $27.37 | $59.30 |
| Standard Option Premiums | ||
|---|---|---|
| Rating Area | Self & Family | |
| BI-WEEKLY | MONTHLY | |
| 1/INTL | $27.67 | $59.95 |
| 2 | $30.31 | $65.67 |
| 3 | $34.40 | $74.53 |
| 4 | $37.12 | $80.43 |
| 5 | $41.05 | $88.94 |
If you have further questions, call Customer Service at 1-855-504-2583 in the U.S. or 1-651-994-2583 collect outside the U.S.
Average Cost Savings
BCBS FEP Dental has a larger nationwide network with over 488,000 provider access points. Use our Find a Provider tool to locate a dentist in the BCBS FEP Dental network or call us at 1-855-504-2583 for assistance.
| What you pay with High Option* | What you pay with High Option* | What you pay with Standard Option* | Average cost without BCBS FEP Dental | ||||
|---|---|---|---|---|---|---|---|
| Two Dental Exams | $0 | $0 | $120 | ||||
| Three Cleanings | $0 | $0 | $300 | ||||
| One Set of X-rays | $0 | $0 | $170 | ||||
| One Root Canal (molar) | $450 | $580 | $1,570 | ||||
| One Crown (porcelain) | $435 | $565 | $1,540 | ||||
| What you pay out-of-pocket | $885 | $1,145 | $3,700 | ||||
| *Assumes you visit in-network providers. | |||||||
| What you pay with Standard Option* | |
|---|---|
| Two Dental Exams | $0 |
| Three Cleanings | $0 |
| One Set of X-rays | $0 |
| One Root Canal (molar) | $580 |
| One Crown (porcelain) | $565 |
| What you pay out-of-pocket | $1,145 |
| Average cost without BCBS FEP Dental | |||
|---|---|---|---|
| Two Dental Exams | $120 | ||
| Three Cleanings | $300 | ||
| One Set of X-rays | $170 | ||
| One Root Canal (molar) | $1,570 | ||
| One Crown (porcelain) | $1,540 | ||
| What you pay out-of-pocket | $3,700 | ||
| *Assumes you visit in-network providers. | |||
Source: https://www.bcbsfepdental.com/benefits
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