Federal Blue Cross Blue Shield 2018 Dental Rates

What's New in 2022

Here are some of the new ways we're supporting your smile in 2022:

Standard Option Changes

  • We now provide in-network benefits for Class A, Class B, and Class C services at 100% for children age 13 and under.
  • Download the full brochure here:

What's New FAQ

What's changing?

New for 2022 with Standard Option now classes A,B,C are covered at 100% for children age 13 and under when visiting an in-network provider.

Do I need to do anything?

No. No action is needed on your part if you're happy with your coverage. It will automatically roll over.

Will I have access to the same network of providers?

Yes. In fact, your network may have expanded. You can search for providers in our network at bcbsfepdental.com/findadentist.

Will I receive a new member ID card?

No. Current members can continue to use their existing member ID card.

Has the customer service number changed?

No. The number has not changed. You may call BCBS FEP Dental at 1-855-504-BLUE (2583). You can also find this number on the back of your member ID card.

Understanding Your Dental Benefits

Understanding your�Blue Cross Blue Shield�FEP Dental coverage is the key to making the most of your benefits, keeping your smile healthy and protecting your overall health.

Need help understanding and choosing a benefit plan? Our AskBlueSM BCBS FEP Dental Plan Finder tool can help you select the right plan for your needs.

We want you to be informed so that you can get the most appropriate and cost-effective care. Check out our Member Education Materials to get more information about�Blue Cross Blue Shield�FEP Dental's value and offerings.

Benefits Chart Benefits Chart - High Option
High Option High Option Standard Option
You pay
IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK
Class A (Basic) Services e.g., exams, cleanings, X-rays, sealants Nothing 10% Nothing 40%
Class B (Intermediate) Services e.g., oral surgery, fillings, gum scaling 30% 40% 45% 60%
Class C (Major) Services e.g., crowns, bridges, implants, root canals, dentures 50% 60% 65% 80%
Annual Deductible for Class A, B and C Services Does not apply to Class D (Orthodontics) $0 $50 per person $0 $75 per person
Class D (Orthodontics) Services Adults & Children 50% up to $3,500 lifetime maximum per person 50% up to $3,500 lifetime maximum per person 50% up to $2,500 lifetime maximum per person 50% up to $1,250 lifetime maximum per person
Annual Maximum Benefits for Class A, B and C Services Does not apply to Class D (Orthodontics) Unlimited maximum per person We pay $3,000 per person We pay $1,500 per person We pay $750 per person
Benefits Chart - Standard Option
Standard Option
You pay
IN-NETWORK OUT-OF-NETWORK
Class A (Basic) Services e.g., exams, cleanings, X-rays, sealants Nothing 40%
Class B (Intermediate) Services e.g., oral surgery, fillings, gum scaling 45% 60%
Class C (Major) Services e.g., crowns, bridges, implants, root canals, dentures 65% 80%
Annual Deductible for Class A, B and C Services Does not apply to Class D (Orthodontics) $0 $75 per person
Class D (Orthodontics) Services Adults & Children 50% up to $2,500 lifetime maximum per person 50% up to $1,250 lifetime maximum per person
Annual Maximum Benefits for Class A, B and C Services Does not apply to Class D (Orthodontics) We pay $1,500 per person We pay $750 per person

Understanding Your Dental Premium

We calculate our dental premiums based on your location (rating areas) and the plan option you select.

Use our Premium Finder to easily find your premium amount or take a look at the tables below to determine your premiums.

To find your premium, locate your state and/or zip code in the rating area table below and to identify your rating area.

Rating Area Chart - Section 1 Rating Area Chart
State First 3 digits of your ZIP Code Rating Area
AK Entire State 5
AL Entire state 1
AR Entire state 2
AZ 855, 859-860, 863-865 2
AZ 850-853 3
AZ Rest of state 1
CA 900-908, 910-928, 930-931, 933-935 4
CA 900-908, 910-928, 930-931, 933-935 4
CA 939-952, 954, 956-959 5
CA 939-952, 954, 956-959 5
CA Rest of state 2
CO Entire state 4
CT 060-063 5
CT Rest of state 4
DC Entire area 3
DE Entire state 2
FL 330-334, 349 2
FL 330-334, 349 2
FL Rest of state 1
GA Entire state 1
GU Entire area 1
HI Entire state 3
IA 500-514, 516, 520-528 3
IA Rest of state 2
ID Entire state 4
IL 600-609, 613 2
IL 612 3
IL Rest of state 1
IN 463-464 2
IN Rest of state 1
KS 664-665, 667-679 2
KS Rest of state 1
KY Entire state 1
LA Entire state 1
MA 010-011, 013-027, 055 5
MA Rest of state 3
MD 205-212, 214, 216-217 3
MD Rest of state 2
ME 039-042 5
ME Rest of state 2
MI 480-485 2
MI Rest of state 1
MN 550-551, 553-555, 563 4
MN Rest of state 3
MO 726 2
MO Rest of state 1
MS Entire state 1
MT Entire state 1
NC 270-274, 278, 280-282, 284-289 2
NC 275-277, 283 3
NC Rest of state 1
ND Entire state 5
NE Entire state 2
NH 030-033, 038 5
NH Rest of state 3
NJ 070-079, 085-089 4
NJ Rest of state 2
NM Entire state 1
NV 897 5
NV Rest of state 2
NY 120-123, 128 3
NY 005, 100-119, 124-126 4
NY 063 5
NY Rest of state 2
OH Entire state 1
OK Entire state 1
OR 970-973 4
OR Rest of state 2
PA 189-196 2
PA 172-174 3
PA 180-181, 183 4
PA Rest of state 1
PR Entire area 1
RI Entire state 5
SC Entire state 2
SD Entire state 1
TN Entire state 1
TX Entire state 1
UT Entire state 2
VA 201, 205, 220-227 3
VA Rest of state 1
VI Entire area 1
VT Entire state 5
WA 980-985 5
WA Rest of state 4
WI 540 4
WI Rest of state 3
WV 254 3
WV Rest of state 1
WY 834 4
WY Rest of state 2
INTL International 1
Rating Area Chart - Section 2
State First 3 digits of your ZIP Code Rating Area
KY Entire state 1
LA Entire state 1
MA 010-011, 013-027, 055 5
MA Rest of state 3
MD 205-212, 214, 216-217 3
MD Rest of state 2
ME 039-042 5
ME Rest of state 2
MI 480-485 2
MI Rest of state 1
MN 550-551, 553-555, 563 4
MN Rest of state 3
MO 726 2
MO Rest of state 1
MS Entire state 1
MT Entire state 1
NC 270-274, 278, 280-282, 284-289 2
NC 275-277, 283 3
NC Rest of state 1
ND Entire state 5
NE Entire state 2
NH 030-033, 038 5
NH Rest of state 3
NJ 070-079, 085-089 4
NJ Rest of state 2
NM Entire state 1
NV 897 5
NV Rest of state 2
NY 120-123, 128 3
NY 005, 100-119, 124-126 4
NY 063 5
Rating Area Chart - Section 3
State First 3 digits of your ZIP Code Rating Area
NY Rest of state 2
OH Entire state 1
OK Entire state 1
OR 970-973 4
OR Rest of state 2
PA 189-196 2
PA 172-174 3
PA 180-181, 183 4
PA Rest of state 1
PR Entire area 1
RI Entire state 5
SC Entire state 2
SD Entire state 1
TN Entire state 1
TX Entire state 1
UT Entire state 2
VA 201, 205, 220-227 3
VA Rest of state 1
VI Entire area 1
VT Entire state 5
WA 980-985 5
WA Rest of state 4
WI 540 4
WI Rest of state 3
WV 254 3
WV Rest of state 1
WY 834 4
WY Rest of state 2
INTL International 1

Once you have identified your rating area, you can view premium amounts for our available plans in the premium table below.

Premium High Options Chart Premium High Options Chart - Self Only
High Option Premiums
Rating Area Self Only Self + One Self & Family
BI-WEEKLY MONTHLY BI-WEEKLY MONTHLY BI-WEEKLY MONTHLY
1/INTL $18.05 $39.11 $36.11 $78.24 $54.16 $117.35
2 $20.22 $43.81 $40.44 $87.62 $60.66 $131.43
3 $22.01 $47.69 $44.03 $95.40 $66.04 $143.09
4 $23.84 $51.65 $47.68 $103.31 $71.52 $154.96
5 $26.68 $57.81 $53.35 $115.59 $80.03 $173.40
Premium High Options Chart - Self + one
High Option Premiums
Rating Area Self + One
BI-WEEKLY MONTHLY
1/INTL $36.11 $78.24
2 $40.44 $87.62
3 $44.03 $95.40
4 $47.68 $103.31
5 $53.35 $115.59
Premium High Options Chart - Self and Family
High Option Premiums
Rating Area Self & Family
BI-WEEKLY MONTHLY
1/INTL $54.16 $117.35
2 $60.66 $131.43
3 $66.04 $143.09
4 $71.52 $154.96
5 $80.03 $173.40

Premium Standard Options Chart Premium Standard Options Chart - Self Only
Standard Option Premiums
Rating Area Self Only Self + One Self & Family
BI-WEEKLY MONTHLY BI-WEEKLY MONTHLY BI-WEEKLY MONTHLY
1/INTL $9.22 $19.98 $18.44 $39.95 $27.67 $59.95
2 $10.10 $21.88 $20.21 $43.79 $30.31 $65.67
3 $11.48 $24.87 $22.95 $49.73 $34.40 $74.53
4 $12.39 $26.85 $24.76 $53.65 $37.12 $80.43
5 $13.68 $29.64 $27.37 $59.30 $41.05 $88.94
Premium Standard Options Chart - Self + one
Standard Option Premiums
Rating Area Self + One
BI-WEEKLY MONTHLY
1/INTL $18.44 $39.95
2 $20.21 $43.79
3 $22.95 $49.73
4 $24.76 $53.65
5 $27.37 $59.30
Premium Standard Options Chart - Self and Family
Standard Option Premiums
Rating Area Self & Family
BI-WEEKLY MONTHLY
1/INTL $27.67 $59.95
2 $30.31 $65.67
3 $34.40 $74.53
4 $37.12 $80.43
5 $41.05 $88.94

If you have further questions, call Customer Service at 1-855-504-2583 in the U.S. or 1-651-994-2583 collect outside the U.S.

Average Cost Savings

BCBS FEP Dental has a larger nationwide network with over 488,000 provider access points. Use our Find a Provider tool to locate a dentist in the BCBS FEP Dental network or call us at 1-855-504-2583 for assistance.

Average Cost Savings Chart Average Cost Savings Chart - What you pay with High Option

What you pay with High Option*

What you pay with High Option*

What you pay with Standard Option*

Average cost without BCBS FEP Dental

Two Dental Exams

$0

$0

$120

Three Cleanings

$0

$0

$300

One Set of X-rays

$0

$0

$170

One Root Canal (molar)

$450

$580

$1,570

One Crown (porcelain)

$435

$565

$1,540

What you pay out-of-pocket

$885

$1,145

$3,700

*Assumes you visit in-network providers.
Average Cost Savings Chart - What you pay with Standard Option

What you pay with Standard Option*

Two Dental Exams

$0

Three Cleanings

$0

One Set of X-rays

$0

One Root Canal (molar)

$580

One Crown (porcelain)

$565

What you pay out-of-pocket

$1,145

Average Cost Savings Chart - Average cost without BCBS FEP Dental

Average cost without BCBS FEP Dental

Two Dental Exams

$120

Three Cleanings

$300

One Set of X-rays

$170

One Root Canal (molar)

$1,570

One Crown (porcelain)

$1,540

What you pay out-of-pocket

$3,700

*Assumes you visit in-network providers.

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Source: https://www.bcbsfepdental.com/benefits

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