2020 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(g). Dental Benefits

 
Important things you should keep in mind about these benefits:
 
  • Please remember that all benefits are subject to the definitions, limitations, and exclusions in this brochure and are payable only when we determine they are medically necessary.
     
  • If you are enrolled in a Federal Employees Dental/Vision Insurance Program (FEDVIP) Dental Plan, your FEHB Plan will be the primary payor for any covered services and your FEDVIP Plan will be secondary to your FEHB Plan. See Section 9, Coordinating Benefits with Medicare and Other Coverage, for additional information.
     
  • Be sure to read Section 4, Your Costs for Covered Services, for valuable information about how cost-sharing works. Also, read Section 9 for information about how we pay if you have other coverage, or if you are age 65 or over.
     
  • The calendar year deductible of $500 per person ($1,000 per Self Plus One or Self and Family enrollment) applies to the accidental injury benefit below.
     
  • You must use Preferred providers in order to receive accidental dental injury benefits for treatment after 72 hours of the accident. Covered services provided more than 72 hours after an accident are subject to the deductible and coinsurance.
 

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