BlueDental Plus and BlueDental Basic Benefit Summaries - District of Columbia
Benefit summaries are now available for the health plans listed below. Please check the site frequently for summary updates.
Spanish benefit summaries are available upon request. Please contact your CareFirst sales representative for more information.
NOTE: Employers can consult with a CareFirst account executive to explore other plan options that fit their organization's benefit needs.
|Plan*||In-Network||Out-of-Network||Annual Max||Dental Summary|
|1||100/80/50||100/80/50||$1,500||SUM2580 (No Ortho)
SUM2592 (With Ortho)
|2||100/80/50||80/60/35||$1,500||SUM2581 (No Ortho)
SUM2593 (With Ortho)
|3||100/80/50||100/80/50||$1,500||SUM2582 (No Ortho)
SUM2594 (With Ortho)
|4||100/80/50||80/60/35||$1,500||SUM2583 (No Ortho)
SUM2595 (With Ortho)
|5||100/80/50||100/80/50||$2,000||SUM2584 (No Ortho)
SUM2596 (With Ortho)
|6||100/80/50||80/60/35||$2,000||SUM2585 (No Ortho)
SUM2597 (With Ortho)
|7||100/80/50||100/80/50||$2,000||SUM2586 (No Ortho)
SUM2598 (With Ortho)
|8||100/80/50||80/60/35||$2,000||SUM2587 (No Ortho)
SUM2599 (With Ortho)
*Plans 1, 2, 5 and 6: Major Surgical Services have the same coinsurance as Basic Services. Plans 3, 4, 7, and 8: Major Surgical Services have the same coinsurance as Major Restorative Services.
HIGHER OUT-OF-NETWORK REIMBURSEMENT AVAILABLE. Talk to your CareFirst account representative about our 90 fee schedule option.