Dental Plan

Choose between two plans or waive coverage.

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BCBSIL
Find a Dentist

Your Choice Overview

DENTAL HMO	DENTAL PPO
See a network dentist or pay the full cost of care	See any dentist you choose but see greater benefits when you stay in network
Preventive and diagnostic procedures covered at 100%
Orthodontia coverage included but varies by plan

Dental Plans at a Glance

		In-Network Dental Coverage Details
	Per Pay Period Cost	Diagnostic & Preventive	Annual Deductible	Annual Maximum Benefit (per person)	Basic Restorative	Major Restorative	Orthodontia
Dental HMO*	Employee Only: $5.35 Employee + 1 Dependent: $10.01 Employee + Family: $16.74	100% covered, no deductible	$0 $0 $0	None	Copays vary based on services needed
Dental PPO	Employee Only: Effective 7/1/2025: $12.80 Effective 9/1/2025: $14.08 Employee + 1 Dependent: Effective 7/1/2025: $30.82 Effective 9/1/2025: $33.89 Employee + Family: Effective 7/1/2025: $38.42 Effective 9/1/2025: $42.24	100% covered, no deductible	Employee Only: $50 Employee + 1 Dependent: $100 Employee + Family: $150	$1,500	You pay 20% after deductible	You pay 50% after deductible	50% coinsurance, $1,500 per member lifetime maximum

*This plan only covers services within its network of providers. If you choose to go out of network, you will pay the full cost of care.

Your Choice Overview

See a network dentist or pay the full cost of care

Preventive and diagnostic procedures covered at 100%

Orthodontia coverage included but varies by plan

See any dentist you choose but see greater benefits when you stay in network

Preventive and diagnostic procedures covered at 100%

Orthodontia coverage included but varies by plan

Dental Plans at a Glance

Select the tab for each plan to review the details.

Per Pay Period Cost	Employee Only: $5.35 Employee +1 Dependent: $10.01 Employee + Family: $16.74
In-Network Dental Coverage Details
Diagnostic & Preventive	100% covered, no deductible
Annual Deductible	$0 $0 $0
Annual Maximum Benefit (per person)	None
Basic Restorative	Copays vary based on services needed
Major Restorative	Copays vary based on services needed
Orthodontia	Copays vary based on services needed

Per Pay Period Cost	Employee Only: Effective 7/1/2025: $12.80 Effective 9/1/2025: $14.08 Employee + 1 Dependent: Effective 7/1/2025: $30.82 Effective 9/1/2025: $33.89 Employee + Family: Effective 7/1/2025: $38.42 Effective 9/1/2025: $42.24
In-Network Dental Coverage Details
Diagnostic & Preventive	100% covered, no deductible
Annual Deductible	Employee Only: $50 Employee + 1 Dependent: $100 Employee + Family: $150
Annual Maximum Benefit (per person)	$1,500
Basic Restorative	You pay 20% after deductible
Major Restorative	You pay 50% after deductible
Orthodontia	50% coinsurance, *$1,500 per member lifetime maximum*

*This plan only covers services within its network of providers. If you choose to go out of network, you will pay the full cost of care.

You pay less when you use network dentists. It’s the only way to get coverage in the Dental HMO, and it’s a better deal to use network dentists in the Dental PPO.

Before choosing a plan, know whether a network dentist is available in your area.

Learn More

BCBSIL
Find a Dentist

ALEX