Dental Plan:

Deductible:

• The individual member deductible is $100
• The family deductible is $200
• There is no deductible for Class I or Class IV services. When you receive covered Class II or III services, you must pay a deductible before payment will be made for these benefits.

Co-pays:

Class of Service:	Coverage Pays:	Your Copay Is:
Class I - Preventative Services	90%	10%
Class II - Restorative Services	90%	10%
Class III - Denture & Bridges	50%	50%
Class IV - Orthodontics Services	50%	50%

 

 

Dollar Maximums:

• $1000 annually for Class I, II and III services combined

• $1000 lifetime for Class IV (orthodontic) services

Every effort is made to provide accurate information. However, this is not a guarantee of payment. Treatment will be rendered based on BCBS's payment liability, we recommend you request a predetermination for your treatment plan prior to having any services rendered. 

Blue Cross Blue Shield of Michigan (BCBS PPO participants)

 

Customer service Office:

225 East Wesley

Jackson, MI

Open 8:30 a.m. – noon and 1:00 – 5:00 p.m.

 

Customer Service Information:

Monday – Friday 8:30 a.m. to 5:00 p.m.

1-800-258-8000

 

Please send all correspondence to:

Blue Cross Blue Shield of Michigan

Costumer Service Center

P.O. Box 2888

Detroit, MI 48231

 

Web Page:

www.bcbsm.com

 

Looking for a provider that participate with BCBS:

http://www.bcbsm.com/directories