A Complete Guide to Blue Cross Dental Insurance in Illinois

Dental insurance from Blue Cross Blue Shield of Illinois (BCBSIL) provides comprehensive dental coverage to help you maintain good oral health. This article outlines everything you need to know about BCBSIL’s dental plan options, benefits, costs, and more.

Overview of Blue Cross Dental Insurance in Illinois

Blue Cross Blue Shield of Illinois offers dental insurance for individuals, families, employers, and Medicare beneficiaries. Their BlueCare Dental plans provide coverage for routine preventive care as well as basic and major dental services.

Some key things to know:

• Available as standalone dental plans or bundled with medical plans
• PPO and HMO dental networks with over 5,000 dentists in IL
• Range of plan options and coverage levels
• Discounted rates when using in-network dentists
• No referrals needed for specialists
• Access to large national dental network

BCBSIL aims to make dental care affordable and accessible to customers throughout Illinois. Their dental plans help cover services to maintain healthy teeth and gums.

Blue Cross Dental Plan Options in Illinois

BCBSIL offers a variety of dental plan designs to meet different needs and budgets:

PPO Plans

• Use any dentist but pay less with in-network providers
• No referrals needed to see specialists
• Access to broad national PPO dental network
• Plans available for individuals, families, employers

HMO Plans

• Lower premiums but limited network
• Set copays for services
• Individual and family plan options
• Must select a primary care dentist

Dental HMO

• Medicaid dental plan for low-income individuals
• Covers children, adults, pregnant women
• Administration through DentaQuest network

Medicare Advantage

• Dental coverage bundled with medical benefits
• All-in-one plans for seniors
• National PPO dental network

Within each plan type, there are options with different coverage levels, deductibles, and premium costs. BCBSIL also offers both employer-sponsored and individual dental plans.

Dental Benefits Covered

BCBSIL’s dental plans cover a wide range of services to maintain dental health. Here are some of the key benefits included:

• Preventive care – cleanings, x-rays, exams
• Basic services – fillings, extractions, root canals
• Major services – crowns, bridges, dentures
• Orthodontia – braces (for children)
• Teledentistry – virtual care options

Plans differ in the percentage covered for each service. Some have copays while others have deductibles and coinsurance. Maximum annual benefits range from $1,000 to unlimited coverage.

Discounted Dental Rates

One advantage of BCBSIL dental insurance is the discounted rates for in-network dentists. PPO plans offer reduced rates up to 30-50% below average costs. This discount applies for all covered services.

Using an in-network dentist saves money since you won’t get charged full price. You have access to the BCBSIL Illinois dental network as well as dentists nationwide.

No Referrals or Waiting Periods

Another perk of BCBSIL dental insurance is you don’t need a referral to see specialists. Whether you need a root canal, braces, or other specialty care, you can make appointments directly without your primary dentist’s referral.

There are also no waiting periods before coverage kicks in. Benefits start right away for cleanings, x-rays, and other basic services. Major work has a 6-12 month waiting period on some plans.

Dental Plan Costs

The cost of BCBSIL dental insurance depends on the plan type, level of coverage, and number of people insured. Here are some examples of average monthly premiums:

| Plan Type | Sample Premiums |
|-|-|-|
| PPO (Individual) | $30 to $60 |
| PPO (Family) | $100 to $200 |
| Dental HMO (Medicaid) | $0 to $25 |
| Medicare Advantage | $12 to $50 |

Deductibles are typically $50 or less. Out-of-pocket costs are lowest for basic preventive care and highest for major work like crowns or bridges. Overall, BCBSIL dental plans provide significant savings compared to paying full price.

Enrollment and Eligibility

Enrollment periods and eligibility for BCBSIL dental plans include:

• Individual plans – Enroll during yearly open enrollment or qualify for special enrollment period.
• Employer plans – Enroll during open enrollment through your workplace.
• Medicare – Enroll during Medicare open enrollment if dental offered in your plan.
• Medicaid – Qualify based on income limits and Illinois residency.

Family members can be added to individual or group dental plans. Coverage continues as long as you pay your monthly premiums and remain eligible.

Finding a Dentist

BCBSIL offers an online dental provider search tool to find in-network dentists near you. You can filter by location, specialty, languages spoken, gender, and more. The directory covers their Illinois network as well as dentists nationwide for PPO plans.

You can visit any dentist but will maximize savings by choosing an in-network provider. Your out-of-pocket costs will be higher if you use an out-of-network dentist.

Waiting Periods

Most routine and basic dental services are covered right away with no waiting period. Major work like crowns, dentures, bridges may have a 6 to 12 month waiting period before coverage kicks in. Orthodontia typically has a 12 month waiting period for children under age 19.

Make sure to check your plan details to understand applicable waiting periods. You’ll pay full price out-of-pocket for any non-covered services during waiting periods.

Covered Dental Services

Here is an overview of common dental services and what’s typically covered under BCBSIL dental plans:

Preventive Services

• Oral exams – 2 per year
• Cleanings – 2 per year
• X-rays – limits apply
• Fluoride (kids) – 2 per year

Basic Restorative Services

• Fillings
• Simple extractions
• Root canals (anterior teeth)
• Stainless steel crowns

Major Restorative Services

• Crowns, inlays, onlays
• Bridges, dentures
• Root canals (posterior teeth)
• Complex extractions
• Periodontal services

Orthodontia Services

• Braces for under age 19
• Limited medically necessary orthodontia over age 19

Exclusions and Limitations

Some limitations and exclusions apply to BCBSIL dental plans:

• Cosmetic dentistry is not covered
• Teeth whitening is not covered
• Coverage limits apply to some services
• Only anterior root canals are covered on basic plans
• Replacement timeframes may apply for crowns, dentures

Be sure to check your plan details for a full list of exclusions and limitations. This can help avoid unexpected costs for non-covered services.

Steps to Enroll in a BCBSIL Dental Plan

Follow these steps if you are interested in enrolling in a Blue Cross Blue Shield of Illinois dental insurance plan:

1. Review available BCBSIL plans and benefits on their website or through a licensed insurance agent.

2. Estimate your costs using the plan finder tool.

3. Pick a plan option that fits your budget and dental needs.

4. Start enrollment online, through an agent, or by submitting an application.

5. Provide eligibility and payment information to complete enrollment.

6. Receive your dental insurance ID cards and policy paperwork.

7. Search the dental provider directory and schedule a checkup.

Contact Information for BCBSIL

To learn more or enroll in a BCBSIL dental insurance plan, you can:

• Call 866-285-9944
• Visit a local BCBSIL agent
• Enroll online at www.bcbsil.com

Their customer service team can answer questions and help you select the right dental plan for your needs and budget.