Dental Blue® Select SM

For Members

Login to Your Dental Blue Select Portal 

Once you do, you will be able to:

  • Manage your plan
  • View your benefit booklet
  • View claims and statements

 

Dental Blue Select Login

Have questions? Dental Blue Select FAQ

Want to know what's covered?

Have more questions? Contact us.


Find a Dentist

You're free to visit any licensed dentist, but you can save money by choosing a participating dental provider.

Find a dentist

Not Sure What Plan You Have?

You can check your member ID card to locate your specific dental plan and policy number.

 

Dental Blue Select FAQs

No. There is no waiting period for diagnostic and preventive services such as routine checkups and cleanings. Waiting periods may apply to basic and major services. Please refer to your Benefit Booklet for details on your specific dental plan.

No, there is no annual deductible. Dental Blue Select features a $100 lifetime deductible that applies to all services (diagnostic and preventive, basic and major services), except orthodontia services. Orthodontia services do not have a deductible.

Orthodontia service is an optional benefit which your employer can choose to include in coverage. Please contact your Group Administrator or refer to your Benefit Booklet to determine if Orthodontia is part of your plan

Yes, you will have an ID card for your medical plan and a different ID card for your Dental Blue Select plan.

Please call Dental Blue Select Claim Customer Service at 1-888-471-2738.

Most dentists will file a claim on your behalf, then bill you for any charges not covered under your Blue Cross NC plan. If your dentist will not file the claim for you, pay the dentist at your visit and submit your claim to Blue Cross NC for reimbursement.

Download the Dental Blue Select claim form, complete it and mail to:

Blue Cross NC
Dental Blue Select Claims Unit
PO Box 2400
Winston-Salem, NC 27102

What's Covered

Plan Features Description
Network Available

You may obtain services from any licensed dentist. Save out-of-pocket dental expenses by using a participating dental provider. Non-participating dentists may bill you for any charges over the allowed amount.

Lifetime Deductible — $100 The deductible applies to all covered services (diagnostic and preventive, basic, and major services), except orthodontia services when selected.
Benefit Period Maximum — $1,000 or $1,500 Dental Blue Select provides a $1,000 or $1,500 annual benefit maximum per person on diagnostic and preventive, basic and major services. If Orthodontia coverage is selected, the maximum benefit for orthodontia coverage is a lifetime maximum of $1,000 or $1,500 per eligible member.
Standard and Enhanced Plans Your employer selected either the Standard or the Enhanced dental plan. Please refer to your Benefit Booklet or contact your Group Administrator for details on your specific dental plan.

Standard Plan

Diagnostic & Preventive Services Covered at 100%
  • Routine oral exams (once per Benefit Period)

  • Adult & child cleaning (once per Benefit Period)

  • Bitewing x-rays

  • Pulp testing

  • Annual fluoride treatment (members under 19 years old)

  • Sealants (members age 5 through 15)

  • Palliative emergency treatment & emergency oral examinations

  • Other diagnostic & preventive services
     

Basic Services Covered at 80%
  • Routine Fillings

  • Simple extractions
     

Major Services Covered at 50% 
  • Endodontics (including root canal)

  • Periodontics including

  • Periodontal exam and maintenance

  • Gingival curettage

  • Gingivectomy and gingivoplasty

  • Root Planning and periodontal scaling (once per quandrant every 24 months)

  • Full mouth or panoramic X-rays (once every 36 months)

  • Periapical X-ray

  • Surgical teeth removal and oral surgery

  • Space maintainers (members under 16 years old)

  • Other major services
     

Orthodontia Services (if selected) Covered at 50% 
  • Endodontics (including root canal)

  • Periodontics including

  • Periodontal exam and maintenance

  • Gingival curettage

  • Gingivectomy and gingivoplasty

  • Root Planning and periodontal scaling (once per quandrant every 24 months)

  • Full mouth or panoramic X-rays (once every 36 months)

  • Periapical X-ray

  • Surgical teeth removal and oral surgery

  • Space maintainers (members under 16 years old)

  • Other major services

Complete Plan

Diagnostic & Preventive Services Covered at 100%
  • Routine oral exams (twice per Benefit Period)

  • Adult & child cleaning (twice per Benefit Period)

  • Bitewing x-rays

  • Pulp testing

  • Annual fluoride treatment (members under 19 years old only)

  • Sealants (members age 5 through 15)

  • Palliative emergency treatment & emergency oral examinations

  • Other diagnostic & preventive services
     

Basic Services Covered at 80%
  • Routine fillings

  • Simple extractions

Major Services Covered at 50%
  • Surgical teeth removal and oral surgery

  • Space maintainers (members under 16 years old)

  • Major Restorative Services

  • Inlays and Onlays (once per 5 years)

  • Crowns

  • Prosthodontics (Bridges, Dentures)

  • Recementation and repair of crowns, inlays, bridges

  • Other major services

 

Orthodontia Services (if selected) Covered at 50%
  • Diagnosis, examination, study models, radiographs

  • Appliance, including design, making placement & adjustment of device

  • Phase I — Minor orthodontic treatment

  • Phase II — Comprehensive orthodontic treatment
     

    * Limited to children under 19 years old

    * No deductible

    * Lifetime benefit maximum of $1,000 or $1,500

Enhanced Plan

Diagnostic & Preventive Services Covered at 100%
  • Routine oral exams (twice per Benefit Period)

  • Adult & child cleaning (twice per Benefit Period)

  • Bitewing x-rays

  • Pulp testing

  • Annual fluoride treatment (members under 19 years old only)

  • Sealants (members age 5 through 15)

  • Palliative emergency treatment & emergency oral examinations

  • Other diagnostic & preventive services
     

Basic Services Covered at 80%
  • Routine fillings

  • Simple extractions

  • Endodontics (including root canal)

  • Periodontics including

  • Periodontal exam and maintenance

  • Gingival curettage

  • Gingivectomy and gingivoplasty

  • Root Planning and periodontal scaling (once per quandrant every 24 months)

  • Full mouth or panoramic X-rays (once every 36 months)

  • Periapical X-ray

  • Other basic services
     

Major Services Covered at 50%
  • Surgical teeth removal and oral surgery

  • Space maintainers (members under 16 years old)

  • Major Restorative Services

  • Inlays and Onlays (once per 5 years)

  • Crowns

  • Prosthodontics (Bridges, Dentures)

  • Recementation and repair of crowns, inlays, bridges

  • Dental Implants (available only on Enhanced Plan)

  • Other major services

 

Orthodontia Services (if selected) Covered at 50%
  • Diagnosis, examination, study models, radiographs

  • Appliance, including design, making placement & adjustment of device

  • Phase I — Minor orthodontic treatment

  • Phase II — Comprehensive orthodontic treatment
     

    * Limited to children under 19 years old

    * No deductible

    * Lifetime benefit maximum of $1,000 or $1,500

 

* Based on the allowed amount, as determined by Blue Cross NC. The allowed amount may be substantially less than the provider's actual charge. You will be responsible for the charges above the allowed amount, in addition to any deductible and coinsurance applied.