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Essential Traditional

Blue Dental Essential Traditional offers comprehensive benefits at a lower premium cost with slightly higher out-of-pocket cost for covered services.

Essential Traditional



Advantage Plus


Two out of three dollar signs for cost and three umbrellas out of three for coverage
Here are some plan features and benefits:
  • Coverage for major services such as dental surgery, root canals and crowns
  • Annual benefit maximum of $1,000
  • $75 annual deductible per member
  • No out-of-pocket costs and no deductible for preventive dental care – exams and cleanings
  • Coverage for simple extractions and fillings
  • Same level of coverage for adults and children

Essential Traditional

Deductible per member1 $75
Benefit Maximum per member (in and out of network) $1,000
Diagnostic and Preventive Services Coinsurance (Contract Pays) Waiting Period
Routine Oral Exams, Cleanings and Consultations 100% None
All Oral X-Rays 50% None
Fluoride Treatments, Sealants 100% None
Palliative Treatment (Emergency) 80% None
Basic Services Coinsurance (Contract Pays) Waiting Period
Space Maintainers 50% None
Fillings, Endodontic Therapy, Root Canal 50% 6 month
Periodontics, General Anesthesia/Sedation, Prosthetic Repairs 50% 12 month
Simple Extractions 50% None
Surgical Extractions, Oral Surgery 50% 12 month
Crown Repair 50% 12 month
Major Services Coinsurance (Contract Pays) Waiting Period
Bridges, Dentures, Inlays, Onlays, Crowns 50% 12 month
Orthodontics Not Covered N/A
1Does not apply to diagnostic and preventive services
See contract and schedule of benefits for coverage exclusions and limitations
To take full advantage of your Blue Dental coverage, choose a dentist who participates in the Advantage Plus network* Dentists in the Advantage Plus network provide covered services at a significant saving.