2025 Blue DentalSM EPO 80/50/50 (0/0/0) with Vision
This plan only covers dental care you get from dentists in our nationwide preferred network. For vision care, you can see any VSP eye doctor.
Overview
About this plan
This EPO plan only covers care from Tier 1 dentists — dentists who are in our nationwide PPO network. But with more than 3,600 PPO dentists in Michigan, and thousands more nationwide, it's easy to find a Tier 1 PPO in-network dentist. Your monthly payments for this all-ages dental plan will be lower than our other plans, and these dentists give you the most savings on services such as cleanings, X-rays and fillings.
Availability
You can buy this plan if you live in any Michigan county except Iron, Keweenaw or Ontonagon.
Plan type
EPO. Your dental care is only covered if you see a Tier 1 PPO in-network dentist. There's no out-of-network coverage.
Monthly premiums
To give you an accurate price, we'll need some information. Find a plan to get a quote.
Deductible for dental care
Your deductible is the amount you pay for dental services each year before your insurance begins to pay.
Coinsurance for dental care
Your coinsurance is your share of the costs of a service. It's usually figured as a percentage of the amount we allow to be charged for services. You start paying coinsurance after you’ve met your plan’s deductible
Annual benefit maximum for adult dental care
This is the limit on what your plan pays for dental care benefits for members who are 19 or older when their plan starts. After reaching that limit for the year, you pay for 100% of your dental care.
Annual out-of-pocket max for pediatric dental care
This out-of-pocket maximum is the most you’ll have to pay during a calendar year for covered pediatric dental services. Once you’ve reached this out-of-pocket maximum, your plan pays 100 percent of the allowed amount.
Your coinsurance is your share of the costs of a service. It's usually figured as a percentage of the amount we allow to be charged for services. You start paying coinsurance after you’ve met your plan’s deductible
Agent compensation
Members can find information about agent commissions.
Related documents
Adult vision care
Coverage includes:
- One eye exam every 12 months
- One pair of standard frames every 24 months
You choose between coverage for prescription glasses (lenses and frame) or contact lenses, but not both:
- Contacts covered once every 12 months, or
- One pair of standard lenses covered once every 12 months
Costs include:
- Copay is $10 for an eye exam by an in-network provider.
- If you go to an in-network provider, the copay for glasses is $25 and you have a $130 allowance for frames or elective contact lenses.
Agent compensation
Members can find information about agent commissions.
Eligibility
Adult members are age 19 or older at the start of the coverage year.
Plan benefits
Your dental care is only covered if you see a Tier 1 PPO in-network dentist. There is no out-of-network coverage.
Class I coverage
Preventive care like exams and cleanings. There is no waiting period for Class I services.
Fluoride treatments
Not covered.
Class II coverage
Basic services like fillings and root canals. These services are covered six months after you first join a Blue Dental plan.
Class III coverage
Major services like crowns and bridges. These services are covered 12 months after you first join a Blue Dental plan.
Implants
Not covered.
Class IV coverage
Orthodontic services
Not covered
Eligibility for pediatric dental
Children can get pediatric benefits until the end of the calendar year in which they turn 19. There is no waiting period for pediatric dental.
Plan benefits
For dental care, you can go to any licensed dentist and this plan will share the cost. But you'll pay less if you see a Tier 1 PPO in-network dentist.
Class I coverage
Preventive care like exams and cleanings.
Class II coverage
Basic services like fillings and root canals.
Sealants
Sealants are covered once per fully erupted first and second permanent molar every 36 months for members to the end of the month of their 16th birthday.
Fillings
Limited to once per tooth and surface every 24 months for primary teeth, and once per tooth and surface every 48 months for permanent teeth.
Class III coverage
Major services like crowns and bridges.
Bridges and dentures
Complete dentures covered once per arch every 84 months; partial dentures and bridges covered once per arch every 84 months for members age 16 and older.
Implants
Not covered.
Class IV coverage
Orthodontic services
Not covered
In-network benefits
When you go to an eye doctor who participates with VSP, that's called getting your care in network. Find a VSP eye doctor.
You're also covered when you go to an eye doctor who doesn't participate with VSP, but you'll pay more. That's called getting your care out of network.
Annual allowance
There's a limit on what your plan pays toward the cost of eyeglasses or contacts. It's called an annual allowance. Once you've reached that limit, you're responsible for paying all costs.
Lenses and frames
Every 12 months this plan shares the costs for prescription eyeglasses or contact lenses, but not both.
Standard lenses
Standard lenses prescribed by an eye doctor, optometrist or optician are covered once every 12 months.
A single copay applies to both lenses and frames.
Standard frames
Standard frames are covered once every 12 months.
A single copay applies to both lenses and frames.
Contact lenses
Every 12 months, this plan shares the costs for eyeglasses or contact lenses, not both.
Elective contact lenses
Elective contact lenses are prescribed by an eye doctor, optometrist or optician to improve vision. They are covered once every 12 months.
Medically necessary contact lenses
Medically necessary contact lenses are for people with eye conditions that may be a side effect of an operation or from certain genetically related disorders. They are covered once every 12 months.
Overview
About this plan
This EPO plan only covers care from Tier 1 dentists — dentists who are in our nationwide PPO network. But with more than 3,600 PPO dentists in Michigan, and thousands more nationwide, it's easy to find a Tier 1 PPO in-network dentist. Your monthly payments for this all-ages dental plan will be lower than our other plans, and these dentists give you the most savings on services such as cleanings, X-rays and fillings.
Availability
You can buy this plan if you live in any Michigan county except Iron, Keweenaw or Ontonagon.
Plan type
EPO. Your dental care is only covered if you see a Tier 1 PPO in-network dentist. There's no out-of-network coverage.
Monthly premiums
To give you an accurate price, we'll need some information. Find a plan to get a quote.
Deductible for dental care
Your deductible is the amount you pay for dental services each year before your insurance begins to pay.
Coinsurance for dental care
Your coinsurance is your share of the costs of a service. It's usually figured as a percentage of the amount we allow to be charged for services. You start paying coinsurance after you’ve met your plan’s deductible
Annual benefit maximum for adult dental care
This is the limit on what your plan pays for dental care benefits for members who are 19 or older when their plan starts. After reaching that limit for the year, you pay for 100% of your dental care.
Annual out-of-pocket max for pediatric dental care
This out-of-pocket maximum is the most you’ll have to pay during a calendar year for covered pediatric dental services. Once you’ve reached this out-of-pocket maximum, your plan pays 100 percent of the allowed amount.
Your coinsurance is your share of the costs of a service. It's usually figured as a percentage of the amount we allow to be charged for services. You start paying coinsurance after you’ve met your plan’s deductible
Agent compensation
Members can find information about agent commissions.
Related documents
Adult vision care
Coverage includes:
- One eye exam every 12 months
- One pair of standard frames every 24 months
You choose between coverage for prescription glasses (lenses and frame) or contact lenses, but not both:
- Contacts covered once every 12 months, or
- One pair of standard lenses covered once every 12 months
Costs include:
- Copay is $10 for an eye exam by an in-network provider.
- If you go to an in-network provider, the copay for glasses is $25 and you have a $130 allowance for frames or elective contact lenses.
Agent compensation
Members can find information about agent commissions.
Eligibility
Adult members are age 19 or older at the start of the coverage year.
Plan benefits
Your dental care is only covered if you see a Tier 1 PPO in-network dentist. There is no out-of-network coverage.
Class I coverage
Preventive care like exams and cleanings. There is no waiting period for Class I services.
Fluoride treatments
Not covered.
Class II coverage
Basic services like fillings and root canals. These services are covered six months after you first join a Blue Dental plan.
Class III coverage
Major services like crowns and bridges. These services are covered 12 months after you first join a Blue Dental plan.
Implants
Not covered.
Class IV coverage
Orthodontic services
Not covered
Eligibility for pediatric dental
Children can get pediatric benefits until the end of the calendar year in which they turn 19. There is no waiting period for pediatric dental.
Plan benefits
For dental care, you can go to any licensed dentist and this plan will share the cost. But you'll pay less if you see a Tier 1 PPO in-network dentist.
Class I coverage
Preventive care like exams and cleanings.
Class II coverage
Basic services like fillings and root canals.
Sealants
Sealants are covered once per fully erupted first and second permanent molar every 36 months for members to the end of the month of their 16th birthday.
Fillings
Limited to once per tooth and surface every 24 months for primary teeth, and once per tooth and surface every 48 months for permanent teeth.
Class III coverage
Major services like crowns and bridges.
Bridges and dentures
Complete dentures covered once per arch every 84 months; partial dentures and bridges covered once per arch every 84 months for members age 16 and older.
Implants
Not covered.
Class IV coverage
Orthodontic services
Not covered
In-network benefits
When you go to an eye doctor who participates with VSP, that's called getting your care in network. Find a VSP eye doctor.
You're also covered when you go to an eye doctor who doesn't participate with VSP, but you'll pay more. That's called getting your care out of network.
Annual allowance
There's a limit on what your plan pays toward the cost of eyeglasses or contacts. It's called an annual allowance. Once you've reached that limit, you're responsible for paying all costs.
Lenses and frames
Every 12 months this plan shares the costs for prescription eyeglasses or contact lenses, but not both.
Standard lenses
Standard lenses prescribed by an eye doctor, optometrist or optician are covered once every 12 months.
A single copay applies to both lenses and frames.
Standard frames
Standard frames are covered once every 12 months.
A single copay applies to both lenses and frames.
Contact lenses
Every 12 months, this plan shares the costs for eyeglasses or contact lenses, not both.
Elective contact lenses
Elective contact lenses are prescribed by an eye doctor, optometrist or optician to improve vision. They are covered once every 12 months.
Medically necessary contact lenses
Medically necessary contact lenses are for people with eye conditions that may be a side effect of an operation or from certain genetically related disorders. They are covered once every 12 months.
Actions
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Open enrollment is closed but you can get or change coverage for the remainder of 2025 if you've had one of these qualifying life events.
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