800 468 5744 healthplan@opehw1.com Mon - Fri: 8am - 5pm
BlueCross & BlueShield of Oklahoma | ||
Network: DNoA Preferred | ||
Customer Service: 800 313 5162 | ||
Website: www.bcbsok.com |
$2,500 per individual, per plan year | ||
Once reached, Member is responsible for 100% of dental claims for the remainder of the plan year |
$25 per individual, per plan year |
Free, twice per plan year | ||
Not subject to Deductible | ||
For Cleaning, Polishing, Bite-Wing X-Rays & Prophylaxis |
15% Co-Insurance after Deductible | ||
For Fillings, Simple Extractions, Surgical Removal of Teeth & Root Canals |
40% Co-Insurance after Deductible | ||
For Crowns, Full or Partial Dentures, Bridge Repairs & Occlusal Guards |
50% Co-Insurance | ||
Not Subject to Deductible | ||
For Dependent Children up to Age 26 Only | ||
$1,500 Lifetime Maximum |
45.36 | Member | |||
23.96 | Child | |||
38.10 | Children | |||
56.02 | Spouse | |||
79.98 | Spouse & Child | |||
94.12 | Spouse & Children |