2025 Blue DentalSM PPO Pediatric 80/50/50 (50/50/50)
This plan covers dental care for those who are 18 or younger when the plan starts. When you see a dentist in our preferred network, you’ll pay only 20 percent of the cost for basics like cleanings and fluoride treatments.
Overview
About this plan
This pediatric dental plan is for members who are 18 or younger when the plan starts. It provides access to care from more than 3,600 Tier 1 PPO dentists in Michigan, and thousands more nationwide. This plan also gives you the choice to see out-of-network dentists, but you pay more out of pocket.
Availability
You can buy this plan if you live in any Michigan county.
Plan type
PPO. 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.
Monthly premiums
To give you an accurate price, we'll need some information. Find a plan to get a quote.
Deductible
Your deductible is the amount you pay for dental services each year before your insurance begins to pay.
Coinsurance
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 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.
Agent compensation
Members can find information about agent commissions.
Related documents
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
Overview
About this plan
This pediatric dental plan is for members who are 18 or younger when the plan starts. It provides access to care from more than 3,600 Tier 1 PPO dentists in Michigan, and thousands more nationwide. This plan also gives you the choice to see out-of-network dentists, but you pay more out of pocket.
Availability
You can buy this plan if you live in any Michigan county.
Plan type
PPO. 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.
Monthly premiums
To give you an accurate price, we'll need some information. Find a plan to get a quote.
Deductible
Your deductible is the amount you pay for dental services each year before your insurance begins to pay.
Coinsurance
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 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.
Agent compensation
Members can find information about agent commissions.
Related documents
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
Actions
Download or print your benefit information.
Need medical coverage?
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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