Important: You won’t be able to enroll in a BCBS dental plan unless you’re ALSO currently signing up for a health plan during a Special Enrollment Period. Check out your other dental options here. Open Enrollment for all plans is 11/01/20-12/15/20. We recommend Ameritas Dental as the best alternative in the meantime.
BlueCross BlueShield of Texas Dental Plan
- Dental Plans Brochure
- Application
With the BCBSTX dental plans, you’ll get dental coverage on day one with no deductible required for check-ups, cleanings and other preventive services. Most important, costs are typically reduced when you receive care from any BCBSTX participating network dentists. However, you also have the option to see any dentist not in the network, but your out-of-pocket costs may be higher. Some highlights of Dental Indemnity USA coverage:
- Coverage can be used to provide dental benefits to an individual, spouse, children or any combination of dependents.
- A $50 deductible, based on fee schedule allowances, applies for dental procedures or services received by a covered individual during each benefit year.
- Maximum deductible amount of $150 for family coverage.
- Deductibles do not apply to oral exams, cleanings, fluoride treatments, sealants and X-rays.
- $1,000 orthodontia benefit for children under 19 years old
- For more information on coverage and benefits, view the Dental Outline of Coverage.
Eligibility Requirements
You must enroll in a BCBSTX health plan in order to enroll in the dental plan. You have up to 31 days from the effective date of your policy to enroll. All members on that health plan must be enrolled in Dental Indemnity USA. Once your dental plan is dropped for any reason, you cannot re-enroll unless you reapply for a new health insurance plan. There are three ways to enroll in BlueCare Dental PPO:
- Select ‘YES’ next to the Dental option when you apply online for any qualifying Blue Cross and Blue Shield of Texas health plan.
- Download a paper application and email to [email protected]ihealthagents.com or fax to 847-220-9280.
- Call us at (312) 726-6565
* Includes insured, spouse, and three or more children 1. This document does not contain a complete listing of the exclusion, limitations and conditions that apply to the benefits shown. For full information refer to the member’s certificate of benefits booklet. 2. Annual maximum does not apply to members under age 21. 3. Rates subject to change. 4. Region 1 rates apply to members residing in the following counties: Archer, Austin, Bastrop, Brazoria, Caldwell, Chambers, Clay, Collin, Dallas, Delta, Denton, Ellis, Fort Bend, Galveston, Grayson, Harris, Hays, Hunt, Johnson, Kaufman, Liberty, Montgomery, Parker, Rockwall, San Jacinto, Tarrant, Travis, Waller, Wichita, Williamson and Wise. 5. Region 2 rates apply to all members residing in counties outside Region 1 6 Out of Pocket Maximum only applies to members under age 21. 7. The plans listed above refer to the following plans on your Outline of Coverage: 01 = 1A, 02 = 1B, 03 = 2A, 96 = 4 Kids 1A, 97 = 4 Kids 1B All benefits are based upon the Allowable Amount, which is the amount determined by BCBSTX as the maximum amount eligible for payment of benefits. A Contracting Dentist cannotbalance bill for charges in excess of the Allowable Amount. Benefits for services provided by a Non-Contracting Dentist will be based upon the same Allowable Amount, and it is likely that the Non-Contracting Dentist will balance bill for amounts above this, resulting in higher out-of-pocket expenses.
General Inquiries
1-972-766-6900
Blue Cross and Blue Shield of Texas
1001 E. Lookout Drive
Richardson, TX 75082-4144
FEP Service
4002 Loop 322
Abilene, TX 79602
Claims/Customer Service
Blue Cross and Blue Shield of Texas
P.O. Box 660044
Dallas, TX 75266-0044
Precertification
Disease/Care Management Programs
Asthma
Chronic Obstructive Pulmonary Disease
Congestive Heart Failure
Coronary Artery Disease
Diabetes
If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. For other language assistance or translation services, please call the customer service number for your local Blue Cross and Blue Shield company.
Below you will find the claims address, customer service phone numbers, and plan contact information for all plan administrators. Contact your Human Resources office for more information.
Plan | Claims Address | Customer Service |
Medical – A&M Care Plans Blue Cross and Blue Shield of Texas Group: 039993 | BlueCross BlueShield of Texas, Inc. Claims Division P.O. Box 660044 Dallas, Texas 75266-0044 | (866) 295-1212 //www.bcbstx.com/tamus/ |
Pharmacy – A&M Care Plans Express Scripts Group: TAMUSRX BIN: 610014 | Drugs not purchased with the prescription drug card: Express Scripts P. O. Box 2872 Clinton, IA 52733-2872Mail-order drug claims: Express Scripts P.O. Box 650322 Dallas, TX 75265-0322 | (866) 544-6970 //www.express-scripts.com/ |
Medical – Graduate Student Health Plan Academic HealthPlans (AHP) | Blue Cross and Blue Shield of Texas P.O. Box 660044 Dallas, TX 75266-0044 | (877) 624-7911 //tamus.myahpcare.com/ |
Pharmacy – Graduate Student Employee Prime Therapeutics Group: 117565 BIN: 01551 PCN: BCTX | Prime Therapeutics P.O. Box 660044 Dallas, Texas 75266-0044 | (800) 423-1973 //www.myprime.com/ |
Dental PPO Delta Dental Group: 4170-0001 | Delta Dental Insurance Company Claims Department P.O. Box #1809 Alpharetta, Georgia 30023 | (800) 336-8264 //www.deltadentalins.com/tamus/ |
Dental HMO DeltaCare Dental HMO | N/A | (800) 422-4234 //www.deltadentalins.com/tamus/ |
Vision Superior Vision Group: 036138 | Superior Vision Attn: Claims Processing PO Box 967 Rancho Cordova, CA 95741 | (844) 549-2603 //superiorvision.com/ |
Life The Hartford
| The Hartford Group Life/AD&D Claims Unit P. O. Box 14299 Lexington, KY 40512-4299 E-Mail to: | (800) 523-2233 //thehartford.com/learn/tamus |
Accidental Death and Dismemberment Securian Policy: 33770-G | Securian Attn: Claims Department P. O. Box 64114 St. Paul, MN 55164-0114 | (800) 778-2281 //www.lifebenefits.com/ |
Long-Term Disability New York Life Policy: VDT98005 | New York Life P.O. Box 709015 Dallas, TX 75370-9015 | (800) 362-4462 |
Flexible Spending Accounts Navia Benefit Solutions | Navia Benefit Solutions PO Box 53250 Bellevue, WA 98015 | 1 (800) 669-3539 //naviabenefits.com |