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| Eligibility | Individuals and family members not enrolled in Flexible Blue II or Individual Care Blue Plus* |
| Monthly Rate | Starting at $37.53 |
| Copay: | Preventive services: 25 percent Basic restorative services: 50 percent Major restorative services: 50 percent |
| Deductible: | $50 single/$100 family (two or more) per calendar year on basic and restorative services |
| Annual Maximums: | $1,250 per member for all covered services received in-network |
| Waiting Period: | 6-month waiting period on Class II – Basic Restorative and Class III – Major Restorative services, applied on the effective date of dental coverage |
| Network: | DenteMax dental network ** |
*If you are currently enrolled in Flexible Blue II or Individual Care Blue Plus medical coverage you are not eligible for this product. We do offer Flexible Blue Dental for individuals enrolled in those products. Please refer to Flexible Blue II or Individual Care Blue Plus or call 877-4MY-BLUE (877-469-2583) from 8 a.m. to 6 p.m. Monday through Friday for more information.
** Personal Blue Dental uses the DenteMax*** dental network. Services received from a non-network dentist are not covered.
*** Blue Cross Blue Shield of Michigan uses the DenteMax network for its dental plans. DenteMax is an independent company that provides a network of PPO dentists to Blue members.
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