The State offers dental benefits through Blue Cross of Idaho to eligible employees and their family members. Participation in the plan is automatic for anyone enrolled in one of the State's medical plans. Note: Dental is available only if you participate in a State employee medical plan -- you can't elect dental coverage without electing medical insurance.
For details about the plan, including limitations, exclusions and waiting periods, see the plan contract.
BC of Idaho Participating dentists have agreed to provide services to plan participants at a set schedule of negotiated fees. This means network participating dentists will accept plan benefits plus your share of costs (deductible and coinsurance) as payment in full.
Non-Participating dentists are not limited in how much they may charge. For these dentists, the plan pays covered costs based on BC of Idaho's average fee. If a non-participating dentist happens to charge more than the average fee, you have to pay the extra in addition to any amounts you may owe for the deductible and coinsurance.
To find Participating BC of Idaho Providers, please contact Blue Cross of Idaho, 1-866-804-2253 or go on-line at www.bcidaho.com Go to "Find a Provider" then "Dental", then "PPO"
BC of Idaho Benefits
|Annual Deductible||$25 per person||$25 per person*|
|Annual Maximum Benefit||$1,000 per person, not including orthodontic benefits||$1,000 per person, not including orthodontic benefits|
|Diagnostic and Preventative Services - exams and cleanings (once every six months); x-rays||70% of allowable charges||80% of allowable charges|
|Basic Restorative Services (fillings and repairs)||70% of allowable charges||80% of allowable charges|
|Oral Surgery, Periodontics, Endodontics (root canals)||50% of allowable charges||80% of allowable charges|
|Major Restorative Services (crowns, dentures, bridges)||50% of allowable charges (after 1 year waiting period)||50% of allowable charges (after 1 year waiting period)|
|Orthodontia-Limited to dependents 17 and under||50% of allowable charges up to $1,000 lifetime maximum per child (after 1 year waiting period)||50% of allowable charges up to $1,000 lifetime maximum per child (after 1 year waiting period)|
*Deductible is not required for PPO diagnostic and preventative services.
As an employee, if you elect medical coverage you're required to take dental. But you can decline dental coverage for your dependents anytime you want.
Once you have declined dental coverage for your dependents, you may only add it during an open enrollment period.
Soon after you complete initial enrollment, BC of Idaho will send you a member identification card. When you use a participating dentist, your provider will use the information on your identification card to bill the plan directly and you won't have to make a claim.
If you use a non-participating dentist, you may have to make a claim for reimbursement. If so, submit a detailed invoice from your provider along with your name, employer's name, and subscriber identification number to:
Blue Cross of Idaho
P.O. Box 7408
Boise, ID 83707