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Understand Your Plan

The benefits you receive from Florida Blue help assure good oral health care. The more you understand how your plan works, the more motivated you’ll be to take control of your dental health.

Dental Networks and Finding a Dentist

Most Florida Blue dental plans allow you to choose your dentist. But, you get more from your benefits when you use a dentist who participates in our network. These dentists agree to provide services at discounted rates and file all claims forms for you. Your out-of-pocket costs may also be lower.

You can use our “Find a Dentist” feature to view a list of network providers.

How Claims and Payments Work

A Florida Blue network dentist will handle all claims and paperwork for you. However, if you visit an out-of-network dentist, you may need to file a claim yourself to receive reimbursement.

Coverage Information

When you need care, it’s important to know what your dental plan covers. Our payment for treatment will vary depending on your plan and the dentist you visit. In general, dental procedures covered by insurance are grouped into three categories:

  • Preventive care such as annual or semi-annual office visits for cleaning, X-rays, and sealants which are covered at 100%
  • Basic procedures such as treatments for gum disease, extractions, fillings, and root canals with deductibles, copays, and coinsurance determining your out-of-pocket expenses; most policies cover 70% to 80% of these procedures, with patients paying the remainder
  • Major procedures such as crowns, bridges, inlays, and dentures which are typically only covered at a high copayment, with the patient paying more out-of-pocket expenses than other procedures

Knowing what’s covered under your dental plan and at what cost will help you better manage your care. Visit your online account to get more information.

Review Claims History

Your dental plan has an annual dollar maximum which goes towards the cost of your care. You are responsible for paying any costs above the annual maximum. You can stay on top of your spending by logging into your account to review your claims.

Maximum Rollover

If you don’t use all your benefit dollars (i.e., claims less than your annual maximum), you can roll those remaining dollars to the next year. They can be used to cover unexpected issues, higher out-of-pocket costs for major services, or help you plan for future procedures. With Maximum Rollover, your benefits can add up over time. Check your plan documentation to see whether you are eligible.

Your online account makes it easy to check how many rollover dollars you have.