Dental Blue for Federal Employees
Dental Blue for Federal Employees offers flexibility and freedom: A choice of plan options and the ability to choose any licensed dentist in North Carolina.

Two Options for Greater Flexibility

Dental Plan Options

Both plans (Standard and Basic) feature:

  • Low premiums, convenient monthly payments
  • No deductible or waiting periods for most services
  • Prior coverage credit toward waiting period for orthodontia (for those under the age of 19)
  • Coverage for fillings, gum treatments, crowns, implants and more
  • Coverage for dependent children up to the age of 26
  • You are free to visit any licensed dentist but you may save money by visiting a participating dentist.* View the directory of participating dental providers. Our out-of-state participating providers directory will be available January 1, 2013.

Our Standard Plan also has no waiting period for non-orthodontic services and covers two annual checkups each year.

Our Basic Plan also features no waiting period for non-orthodontic services, including fillings, simple extractions and crowns.

Dental Blue for Federal Employees in Action

When it's time to see a dentist, just follow these simple steps:

  1. Call to schedule an appointment with any licensed dentist.
  2. Present your BCBSNC ID card at the dentist's office.
  3. File your claim. (Dentists in the BCBSNC network will file the claim for you.)

NOTE: Dental Blue for Federal Employees is not part of the covered benefits of any other BCBSNC health plans. It must be purchased separately.

* There are no network restrictions with Dental Blue for Federal Employees. You're free to visit any licensed dentist you choose, but there are advantages to visiting a dentist in our network: You're not responsible for charges over the allowed amount for covered services and dentists in our network file your dental claims for you.

This dental product, offered by BCBSNC, is intended to complement the policy offered to federal employees and retirees by the federal government. This dental product is not approved, endorsed or accredited by the federal government, and it is in no way connected to the federal government or to the U.S. Office of Personnel Management.

What's Covered

Type of Coverage
Plan Benefits
Standard Option
Basic Option

Preventive Services

Standard Option

  • Routine oral exams and cleanings
  • Bitewing X-rays
  • Pulp testing
  • Fluoride treatment (for those under the age of 19)
  • Palliative emergency treatment
  • Emergency oral examinations
  • Sealants and other preventive services

Standard and Basic Options

  • Space maintainers (for those under the age of 13) and other preventive services
  • You pay 0% (plus applicable copayment1).
  • There is no deductible and no waiting period. 2
  • Routine services such as checkups, cleanings, and x-rays are not covered.
  • You pay 0% on some Diagnostic and Preventive services such as palliative treatments, consultations, space maintainers and pulp testing.

Basic Services

  • Fillings
  • Simple extractions
  • Oral surgery
  • Other basic services
  • You pay 35% (plus applicable copayment1) in Year 1 with no deductible and no waiting periods.2
  • In Year 2 and after, you pay 25% (plus applicable copayment1).
  • You pay 35% in Year 1 with no deductible and no waiting periods.2
  • In Year 2 and after, you pay 25%.

Major Services

  • Gingival curettage
  • Gingivectomy and gingivoplasty
  • Endodontics (root canals)
  • Periodontal maintenance
  • Inlays and onlays (once every 8 years)
  • Crowns, bridges, dentures implants and other major services
  • You pay 60% (plus applicable copayment1) in Year 1 with no deductible and no waiting periods.2
  • In Year 2 you pay 55% (plus applicable copayment1) and in Year 3 and after you pay 50% (plus applicable copayment1).
  • You pay 60% in Year 1 with no deductible and no waiting periods.2
  • In Year 2 you pay 55%, and in Year 3 and after you pay 50%.

Orthodontic Services

  • Orthodontic services (members under age 19 only)
  • There is a 24-month waiting period before coverage begins.
  • Once coverage begins you pay 50% with no deductibles and no copayment amounts.
  • There is a $1,500 lifetime maximum per individual.
  • There is a 24-month waiting period before coverage begins.
  • Once coverage begins you pay 50% with no deductibles and no copayment amounts.
  • There is a $1,500 lifetime maximum per individual.

Annual Maximum, all services
(except Orthodontia)

$3,000

$2,500


Dental Blue for Federal Employees Exclusions

Like most health care plans, Dental Blue for Federal Employees has some exclusions.

Monthly Rates3
  Standard Basic

Employee

$34.78 $26.60

Employee + 1

$69.55 $53.21

Family

$104.33 $79.80
Waiting Periods
Diagnostic and Preventive Services None
Basic Services None
Major Services None
Orthodontia 24 months

1 The Standard Option has a copayment for specific procedures.

2 Based on allowed amount, as determined by BCBSNC. The allowed amount may be less than the provider's actual charge. You may be responsible for the charges above the allowed amount if you do not visit a BCBSNC network provider.

3 Benefits and premium depends on plan selected. Rates are effective January 1, 2013 through December 31, 2013. When comparing dental plans, review billing schedules carefully. Dental Blue for Federal Employees can only be billed and paid on a monthly basis. Other plans may bill on a bi-weekly basis.

Dental Blue for Federal Employees is not part of the covered benefits of any other BCBSNC health plans. It must be purchased separately. Coverage for dependent children ends at the age of 26. Your coverage may be cancelled by BCBSNC for failure to pay premiums when due and for fraudulent statements on your application, among other reasons. Members are notified 30 days in advance of change in coverage. You are eligible for Dental Blue for Federal Employees coverage if you are a current federal employee or a retired federal employee. You and your dependents (spouses or dependent children under the age of 26) must be residents of North Carolina. Your actual rate is based on the plan you chose and the number of family members covered. Exclusions apply to this coverage. This dental product, offered by BCBSNC, is intended to complement the policy offered to federal employees and retirees by the federal government. This dental product is not approved, endorsed or accredited by the federal government, and it is in no way connected to the federal government or to the U.S. Office of Personnel Management.

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Get Answers to Common Questions

General Product Info
  • Who is eligible for Dental Blue for Federal Employees1?
  • You are eligible for dental coverage if you are a current federal employee or a retired federal employee. You and your dependents (spouse or dependent children under the age of 26) must be residents of North Carolina.

  • Do I have to have BCBS Federal medical coverage to purchase Dental Blue for Federal Employees?
  • No. Dental Blue for Federal Employees will complement dental coverage under the Federal medical plans, but you do not have to be enrolled in any medical plan to be eligible.

  • Will Dental Blue for Federal Employees complement my BCBS Federal plan?
  • Yes. The Standard Option will complement the BCBS Federal Standard plan; and the Basic Option will complement the BCBS Federal Basic Option plan.

    With the Dental Blue for Federal Employees Standard Option, some dental procedures require a copayment amount. This copayment is equal to the covered fee schedule amount under the BCBS Federal medical plan. For example, if you have a routine cleaning (Procedure D1111 - Adult Prophylaxis), you will have a $16 copayment under this dental plan. If you have Standard Option BCBS Federal medical coverage plan, it will cover $16 for this service. So, you would simply file a claim with both plans (see Claims information below). If you do not have the Standard Option BCBS Federal medical plan, then you will be required to pay the $16 copayment amount under your Dental Blue for Federal Employees plan.

    With the Dental Blue for Federal Employees Basic Option, you get coverage for Basic and Major dental procedures (and some Diagnostic and Preventive procedures) in addition to those covered by the BCBS Federal Basic Option medical plan. For example, fillings and crowns which are not covered by the medical plan would be covered by Dental Blue for Federal Employees Basic Option.

  • If I am currently enrolled in Dental Blue for Individuals, can I apply for Dental Blue for Federal Employees?
  • Yes. When you submit your Dental Blue for Federal Employees application, your Dental Blue for Individuals coverage will terminate and be replaced with Dental Blue for Federal Employees. If for some reason you are declined for Dental Blue for Federal Employees, you can request to reinstate your Dental Blue for Individuals policy within 30 days of cancellation.

  • If I cancel my Dental Blue for Federal Employees coverage, how soon may I reapply?
  • If you choose to cancel your Dental Blue for Federal Employees coverage or it is terminated for any reason, you may not reapply until the next open enrollment date following a 12-month lapse of coverage.

  • How do I change my bank account information for the monthly premium draft?
  • Once you have logged into mybcbsnc.com, you can update your bank account or credit card information for the monthly bank draft.

  • Are my monthly premiums subject to change?
  • You may experience a change in your monthly premiums at the time of your annual renewal, which is January 1 of each year, or when you add or remove dependents.

  • Is Dental Blue for Federal Employees available only during open enrollment?
  • For current federal employees, you must apply for Dental Blue for Federal Employees during the open enrollment period. The easiest and fastest way to apply at fepdentalbluenc.com. Only new employees can apply outside of the open enrollment window, and may enroll online. Paper applications can be downloaded from the website.

  • When can my Dental Blue for Federal Employees coverage begin?
  • Your coverage begins on January 1, 2013. New employees hired outside of the open enrollment period can still apply online or complete a paper application within 60 days of their hire (or transfer into North Carolina) date. The effective date of the policy for new employees will be the first day of the month following at least 15 days after the signature date of the application. Paper applications can be downloaded at fepdentalbluenc.com website.

  • What kind of changes can I make to my policy online?
  • After the effective date of January 1, 2013, you will be able to create a login for access to mybcbsnc.com where you can:

    • change name
    • change physical and/or billing address
    • change e-mail address and/or phone number
    • remove dependents (upon qualifying family status change)
  • Can I change who is covered on the policy?
  • You may apply to cover your eligible dependents under your policy at the time of initial enrollment. You cannot make changes to your enrollment until the next open enrollment period, unless there is a qualifying family status change such as marriage, divorce, the birth/adoption of a child or loss of other group coverage.

Benefits and Coverage
  • What dental services are subject to my deductible amount?
  • Deductibles do not apply to dental services. For the Standard Option, copayment mounts apply to some procedures.

  • Is there an annual limit to coverage?
  • Yes, there is an annual limit to coverage for both the Standard Option and the Basic Option:

    • The Standard Option benefit allows $3,000 of covered services (excluding orthodontia)* each benefit period.
    • The Basic Option benefit allows $2,500 of covered services (excluding orthodontia)* each benefit period.

    Any services above this annual limit will be the responsibility of the patient to pay.

    * For orthodontia services, there is not an annual maximum. However, there is a $1,500 lifetime maximum per individual.

  • Are my children covered for orthodontic services?
  • Yes, dependents up to age 18 are covered for orthodontia services. There is a 24-month waiting period. However, if you can show proof that you have had dental coverage (it does not have to be orthodontia coverage) within 63 days of your effective date, you may receive full or partial credit towards your orthodontia waiting period. To obtain credit once you are enrolled, mail a copy of your certificate of creditable coverage to:

    BCBSNC
    PO Box 30006
    Durham, NC 27702

    Billing and Membership customer service representatives can be reached at 1-888-206-4697.

  • Is there a waiting period for dental services?
  • There is no waiting period except for orthodontia (for dependents under age 19), which has a 24-month waiting period.

Finding a Dentist
  • How do I know if my dental provider is a participating provider in your dental network?
  • You can access the directory of in-network dental providers by using our Find a Doctor or Facility search tool at bcbsnc.com.

  • Do I have to choose a dentist from BCBSNC's participating provider list?
  • We encourage you to use a network provider but you may visit any licensed dentist you wish. However, you'll save out-of-pocket dental expenses if you use a participating dental provider. When you receive covered services from a participating dental provider, you're not responsible for any charges over the allowed amount2. Non-participating dentists will be reimbursed at the allowed amount, but they may bill you for any charges over that amount.

  • If my dependent is in college out of state, are they covered for dental services received in that state?
  • Yes. As long as your dependent is a legal resident of North Carolina, he/she is covered for services received out of state. Use our Find a Doctor or Facility search tool to find a participating dental provider in that state. (Out of state participating providers directory will be available online on January 1, 2013.)

Claims
  • Do I need to file a claim?
  • Participating dentists are required to file the claim for you. Many non-participating dentists will file a claim on your behalf, then bill you for any charges not covered under your BCBSNC plan. If your dentist does not file the claim for you, pay the dentist at your visit and submit your claim to BCBSNC for reimbursement. Dental claim forms can be downloaded at bcbsnc.com.

  • Where do I send my claim form to get reimbursed for dental expenses?
  • To get reimbursed for your dental expenses, complete a dental claim form and mail it along with a receipt from the dentist to us within 180 days from the date of your service. Send the completed claim form to:

    Blue Cross and Blue Shield of North Carolina
    Dental Claims Unit
    PO Box 2100
    Winston-Salem, NC 27102-2100

  • If I have Dental Blue for Federal Employees plan and I have a Federal medical plan, am I required to file dental claims to my medical plan first?
  • No. Although you are not required to file to your medical plan first, you will need to file your dental claim with both plans. Claims information cannot be passed automatically between plans and are not considered primary or secondary. You do not need to wait for either claim to process before submitting both claims. For Dental Blue for Federal Employees, use the claim address above. Consult your Federal medical plan for claims filing addresses.

Pricing
  • How does the Dental Blue for Federal Employees monthly rate compare to a plan billed bi-weekly?
  • Although Dental Blue for Federal Employees can only be billed and paid on a monthly basis, you can use the table below to compare our rates to other bi-weekly dental plans.

 

Standard

Basic

Employee
Monthly
$34.78
Monthly
$26.60
Bi-weekly Equivalent
$16.05
Bi-weekly Equivalent
$12.28
Employee +1
Monthly
$69.55
Monthly
$53.21
Bi-weekly Equivalent
$32.10
Bi-weekly Equivalent
$24.56
Family
Monthly
$104.33
Monthly
$79.80
Bi-weekly Equivalent
$48.15
Bi-weekly Equivalent
$36.83

1 This dental product, offered by BCBSNC, is intended to complement the policy offered to federal employees and retirees by the federal government. This dental product is not approved, endorsed or accredited by the federal government, and it is in no way connected to the federal government or to the U.S. Office of Personnel Management.

2 Allowed amount, as determined by BCBSNC. The allowed amount may be less than the provider's actual charge. You may be responsible for the charges above the allowed amount if you do not visit a network provider.

Benefits and premium depends on plan selected. For costs and further details of the coverage, including exclusions, and reductions or limitations and terms under which the policy may be continued in force, write to P.O. Box 2291, Durham, NC 27707 Attn: FEP Membership.

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How to Contact Us

For product questions and application information, please contact us.

Phone

1-888-802-6941 (toll-free)

TDD

1-800-922-3140 (toll-free)
Monday - Friday, 8 a.m. - 5 p.m.

This dental product, offered by BCBSNC, is intended to complement the policy offered to federal employees and retirees by the federal government. This dental product is not approved, endorsed or accredited by the federal government, and it is in no way connected to the federal government or to the U.S. Office of Personnel Management.