(You will need Adobe Acrobat Reader to view or print items on this page.)
Beginning January 1, 2004, BlueCross will administer the State Dental and Dental Plus Plans. For customer service call 803-264-3702 or toll-free 1-888-214-6230.
State Dental Plan
Your dental benefits are divided into four classes. We pay all benefits on the basis of the Schedule of Dental Procedures and Allowable Charges available from your benefits office. Please note that we do not cover all services under this plan. Please refer to the Exclusions section of your Insurance Benefits Guide or call BlueCross customer service at 803-264-3702 or toll-free 1-888-214-6230.
Understanding Your State Dental Plan Explanation of Benefits
Diagnostic and Preventive Services
- Oral exams
- Cleaning and scaling of teeth
- Fluoride treatment
- Space maintainers (child only)
- Emergency pain relief
- X-rays
Basic Dental Services
- Fillings
- Simple and surgical extractions
- Oral surgery
- Preparation of mouth for dentures
Prosthodontics
- Onlays
- Crowns
- Bridges
- Dentures
- Repair of Prosthodontic Appliances
Orthodontics
- Limited to covered children under age 19
- Correction of malocclusion (including diagnosis, models and radiographs)
- Active treatment (including necessary appliances)
Dental Plus
Dental Plus is an additional dental program that provides a higher level of coverage for dental services covered under the State Dental Plan. You pay the entire premium, with no contribution from the state.
Dental Plus is not an offset program that pays what the State Dental Plan does not. Instead, it covers the same procedures and services (except orthodontics) at the same percentage rate of coverage as the State Dental Plan. The difference is a higher dollar amount allowance for charges.