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Dental Plans

BluePreferred Dental Download Application

BluePreferred Individual Dental PPO plans offer 100% in-network coverage for covered diagnostic and preventive services. This means that common covered services such as two yearly exams and cleanings, and some x-rays are provided with no out-of-pocket expenses when network dentists are used. And the network is extensive with licensed dentists located throughout Arizona. Three different plan designs are available.
This is only a brief summary of benefits to guide your shopping experience and to help you compare plan differences. Please review the plan Benefit Summary for your chosen plan before you apply for coverage.

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BluePreferred Dental

Annual Deductible 

In-Network Coinsurance (Plan Pays / Member Pays) 

Out of Network Coinsurance (Plan Pays / Member Pays) 

Annual Plan Maximum 

Special
Features

BluePreferred Dental Plan 1i

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$50

Type I: 100% / 0%
Type II: 80% / 20%
Type III: Not Covered

Type I: 80% / 20%
Type II: 60% / 40%
Type III: Not Covered

$500

100% In-Network Preventative Coverage*

BluePreferred Dental Plan 5i

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$50

Type I: 100% / 0%
Type II: 80% / 20%
Type III: 50% / 50%

Type I: 80% / 20%
Type II: 60% / 40%
Type III: 40% / 60%

$1,000

Includes Maximum Carryover Provision**

BluePreferred Dental Plan 6i

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$50

Type I: 100% / 0%
Type II: 80% / 20%
Type III: 50% / 50%

Type I: 80% / 20%
Type II: 60% / 40%
Type III: 40% / 60%

$1,500

Includes Maximum Carryover Provision**

Disclaimer and Footnotes

Important Notice: All plans have a 6 month waiting period for type II services and 12-month waiting period for type III services. The annual plan maximum is the most that the plan will pay for covered services during a plan year. After you reach the maximum, no further services are covered. For detailed information about benefits, waiting periods, limitations and exclusions, refer to the specific provisions found within the benefit plan booklet. If the benefits on this comparison differ from those stated in the benefit plan booklet, the terms of the benefit plan booklet apply. There is no guarantee of continued benefits outlined in this comparison or the benefit plan booklet.

*Benefit limitations and exclusions and calendar year maximums apply.

**This feature allows some unused dollars to be carried from one year to another.