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Dental plan options

Capital Blue Cross Dental plans offer the freedom to choose providers and valuable opportunities to save on dental costs. We understand the link between good oral health, and we can help your employees make that connection, too. From preventive care to orthodontics, Capital Blue Cross Dental includes benefits to help your employees live healthy.

PPO dental plans

Plan Office visit copay Deductible Benefit period maximum
Dental PPO Value 75 $15 routine exam None $1000 per member per benefit period
Dental PPO Basic1 None $50 per member
  $150 per family		 $1500 per member per benefit period
Dental PPO Classic1 None $50 per member
  $150 per family		 $1500 per member per benefit period
Dental PPO Plus None $50 per member
  $150 per family		 $1500 per member per benefit period
Dental PPO Choice None $50 per member
  $150 per family		 $1500 per member per benefit period

Select dental plans

Plan Office visit copay Deductible Benefit period maximum
Dental Select 705x $10 None None

2021 plans

PPO dental plans

Plan Office visit copay Deductible Benefit period maximum
Dental PPO Value 75 $15 routine exam None $1000 per member per benefit period
Dental PPO Basic1 None $50 per member
  $150 per family		 $1500 per member per benefit period
Dental PPO Classic1 None $50 per member
  $150 per family		 $1500 per member per benefit period
Dental PPO Plus None $50 per member
  $150 per family		 $1500 per member per benefit period
Dental PPO Choice None $50 per member
  $150 per family		 $1500 per member per benefit period
Dental PPO Max 3000 20% after deductible $250 per member
  no family limit		 $3000 per member per benefit period

Select dental plans

Plan Office visit copay Deductible Benefit period maximum
Dental Select 705x $10 None None

1Also offered on a voluntary basis.

On behalf of Capital Blue Cross, Dominion Dental Services, Inc. assists in the administration of the Capital Blue Cross Dental benefits. Dominion Dental is an independent company.

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