State Dental Plan and Dental Plus
Your teeth are important to your overall health. That is why PEBA offers the State Dental Plan, which helps offset your dental expenses, and Dental Plus, a supplement to the State Dental Plan. To participate in Dental Plus, you must enroll in the State Dental Plan and cover the same family members under both plans.
BlueCross BlueShield of South Carolina processes State Dental Plan and Dental Plus claims. Its address is P.O. Box 100300, Columbia, SC 29202-3300. Its Customer Service numbers are 803.264.7323 and 888.214.6230. The fax number is 803.264.7739.
State Dental Plan
The State Dental Plan offers these levels of treatment: diagnostic and preventive; basic; prosthodontics; and orthodontics. They are described in detail in the Dental Insurance chapter of the Insurance Benefits Guide.
The lifetime orthodontics payment is $1,000 for each covered child age 18 and younger. State Dental Plan benefits are paid based on the allowed amounts for each dental procedure listed in the plan’s Schedule of Dental Procedures and Allowed Amounts, which is included in the Dental Insurance chapter of the Insurance Benefits Guide. Be aware that your dentist’s charge may be greater than the allowed amount.
The maximum yearly benefit for the State Dental Plan alone is $1,000 for each subscriber or covered person. The State Dental Plan deductible is $25 annually for each covered person who has dental services under Class II or Class III. The deductible for family coverage is limited to three per family per year, $75.
Details about the State Dental Plan are in the Dental Insurance chapter of the Insurance Benefits Guide.
Members enrolled in Dental Plus must also be covered by the State Dental Plan. Dental Plus covers the first three levels of treatment at the same percentage as the State Dental Plan; however, the allowed amount is higher.
Dental Plus does not cover orthodontics; however, the State Dental Plan plan offers a $1,000 lifetime orthodontics
benefit for each covered child age 18 and younger. See the Dental Insurance chapter of the Insurance Benefits Guide for more information.
With Dental Plus, payment for a covered service is based on the lesser of the dentist’s charge or the Dental Plus allowed amount. This means you may only be responsible for any deductibles and coinsurance that apply. If your dentist charges more for covered services than the Dental Plus allowed amount, you will be responsible for paying the difference (plus deductibles and coinsurance) unless your dentist has agreed to accept the Dental Plus allowed amount as part of participation in the Dental Plus provider network.
PEBA offers agreements to dentists in South Carolina and contiguous counties to accept the lesser of their usual charge or the Dental Plus allowed amount. For a list of dentists who accept the agreement, go to StateSC.SouthCarolinaBlues.com and select “Find a Provider” in the “Find a Doctor or Hospital” section. Enter your location, then select “Advanced Search” in the main window and follow the prompts.
If your dentist has not accepted PEBA’s agreement, your Dental Plus benefits will not be reduced, but you will be responsible for the difference between your dentist’s charge and the Dental Plus allowed amount plus deductibles and coinsurance.
The maximum yearly benefit for a person covered by both the State Dental Plan and Dental Plus is $2,000. There are no additional deductibles under Dental Plus, but the State Dental Plan deductible is subtracted from the Dental Plus payment, when applicable.
Order a replacement ID card
You may order replacement Dental Plus ID cards by calling BlueCross BlueShield of South Carolina at 888.214.6230, or by visiting the BlueCross website at StateSC.SouthCarolinaBlues.com. You will need your Benefits Identification Number (BIN). If you don’t know your BIN, login to MyBenefits and select “Get My BIN.” If you need a State Dental Plan ID card, you should contact your benefits administrator.
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