Dental Plan Riders
Your annual benefit maximums are based on the calendar year and services will follow you throughout the calendar year even when you switch plans mid-year during open enrollment.
Must stay in the dental rider for a minimum of 1 year. However, in order to receive the full orthodontic benefit, you must stay in the dental rider for a minimum of 2 years.
Participating Dentists
Excellus BlueCross BlueShield offers a broad participating dental network in the Rochester, Syracuse, Utica and surrounding areas. You have the option of receiving care from a dentist of your choice. However, choosing a participating dentist may result in savings for you because participating dentists agree to accept the Schedule of Allowances as payment in full for covered services. Aside from any coinsurance, there is no balance billing for covered services when provided by a participating dentist-that’s full coverage with no out-of-pocket expense for your covered routine preventive and diagnostic services.
You now have National GRID Dental + DenteMax
National GRID + DenteMax is a network of multiple Blue Cross and Blue Shield Plans that, when combined, offers one of the largest national PPO dental networks and provides patients with lower out-of-pocket costs and broad access to participating dentists.
Non-participating Dentists
Dental Blue plans give you the freedom to see any dentist. Non-participating dentists are not obligated to accept the Schedule of Allowances. You will be responsible for balances of non-participating dentists’ charges.
To view the complete GAHP Dental Benefit Booklet click here
To compare the GAHP Dental plans, click here
Dental Blue Basic
Dental Blue Basic represents a plan design to encourage preventive care and early treatment and also includes coverage for specialized treatment.
Preventive/Diagnostic Services are paid at 50 percent of the BlueShield Fee Schedule.
For Restorative Services, there is an individual deductible of $75.00 and a family deductible of $150.00. Restorative Services are paid at 50 percent of the BlueShield Fee Schedule.
Orthodontia Services cover no more than $750 per individual’s lifetime up to age 19. The orthodontia benefit is split into two payments with one-half of the total orthodontia maximum paid in year one and the other half paid in year two.
For all other covered services (excluding orthodontia), the maximum payable in a calendar year is $500 per individual.
Please click on the Dental Basic Plan Summary link to view the benefit summary.
Dental Blue Select
Dental Blue Select represents an enhanced plan design to encourage preventive care and early treatment and also includes coverage for specialized treatment.
Preventive/Diagnostic Services are paid at 100 percent of the BlueShield Fee Schedule.
For Restorative Services, there is an individual deductible of $25.00 and a family deductible of $75.00.
Restorative Services are paid at 50 percent of the BlueShield Fee Schedule.
Orthodontia Services cover no more than $1,000 per individual’s lifetime up to age 19. The orthodontia benefit is split into two payments with one-half of the total orthodontia maximum paid in year one and the other half paid in year two.
For all other covered services (excluding orthodontia), the maximum payable in a calendar year is $1,000 per individual.
Please click on the Dental Select Plan Summary link to view the benefit summary.
Dental Blue Premier
Dental Blue Premier represents an enhanced plan design to encourage preventive care and early treatment and also includes coverage for specialized treatment.
Preventive/Diagnostic Services are paid at 100 percent of the BlueShield Fee Schedule.
For Restorative Services, there is an individual deductible of $25.00 and a family deductible of $75.00.
Restorative Services are paid at 100 percent of the BlueShield Fee Schedule.
Orthodontia Services cover no more than $1,500 per individual’s lifetime. The orthodontia benefit is split into two payments with one-half of the total orthodontia maximum paid in year one and the other half paid in year two.
For all other covered services (excluding orthodontia), the maximum payable in a calendar year is $1,500 per individual.
Please click on this Dental Premier Plan Summary link to view the benefit summary.