Dental

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Dental Insurance

In addition to protecting your smile, dental insurance helps pay for dental care and includes regular checkups, cleanings and X-rays. Several studies suggest that oral diseases, such as periodontitis (gum disease), can affect other areas of your body-including your heart. Receiving regular dental care can protect you and your family from the high cost of dental disease and surgery.
Out of Network Claims: If you receive services from a provider that is not in the BCBSND network, you may be responsible for the difference between the amount billed and the amount allowed by Blue Cross Blue Shield of ND.
To find a provider, go to www.bcbsnd.com/web/guest/find-a-doctor or refer to the BCBSND provider directory.

The dental plan is administered by Blue Cross Blue Shield of North Dakota (Plan 103). Following is a summary of the plan.

Covered Services	In Network Benefits
Annual Deductible	$50 per person $100 per family
Annual Plan Maximum	$1,000 per member
Diagnostic / Preventative Care Annual Checkups, X-rays, Fluoride Treatments	The plan pays 100%, not subject to deductible
Basic and Restorative Services
Fillings, Sealants, Space Maintainers	After deductible, plan pays 80%
Simple and Surgical Extractions	After deductible, plan pays 80%
Endodontic and Periodontal Services	After deductible, plan pays 80%
Prescription Drugs
Implants	After deductible, plan pays 50%
Prosthodontics (Dentures)	After deductible, plan pays 50%
Inlays, Onlays and Crowns	After deductible, plan pays 50%
Oral Surgery	After deductible, plan pays 50%
Orthodontics
Orthodontic Services	Not covered

How much does the dental plan cost?

Dental Insurance BCBSND Plan 103	Monthly Total	Employer Pays	Employee Pays
Employee Only	$34.40	$22 (63% of premium)	$12.40 ($6.20/check)
Family	$88.30	$59 (66% of premium)	$29.30 ($14.65/check)