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Blue Dental PPO 100/50/50
Healthcare.gov Individual Dental Plan Finder
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Blue Dental PPO 100/50/50

Overview
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Blue Dental PPO 100/50/50 is an individual dental health plan issued by Blue Cross Blue Shield of Michigan Mutual Insurance Company and is available for the year 2019. This dental plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Do I Need to Buy a Dental Plan?

Some but not all health plans offer dental coverage. If your health plan does not include dental coverage, you can purchase a stand-alone dental plan.

However, you cannot buy a dental plan from the government healthcare marketplace, unless you are also buying a health plan at the same time.

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Roscommon county, Michigan.

What Type of Dental Plan Is This?

This plan is a PPO plan, which is also known as a "Preferred Provider Organization." In this type of insurance plan, you can choose to receive care from doctors, hospitals, and other providers who are in-network or out-of-network. You pay less if you use in-network providers. In a PPO plan, you can visit any doctor without getting a referral.

This is a higher premium, lower copay and deductible plan. This means you pay more every month, but you will pay less when you use dental services. This plan is better for those who plan not to use a lot of dental services.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Blue Cross Blue Shield of Michigan Mutual Insurance Company
Plan ID
15560MI0720003
Coverage area
Roscommon County, Michigan
Phone
Local Phone: 1-888-288-2738
Toll-Free: 1-888-288-2738
TTY: 1-800-481-8704
Plan type
PPO
Coverage type
Child only option
Allows Adult and Child-Only
Deductible
$25
Out-of-Pocket Maximum
$350
Coverage
Adult Dental Coverage
Child Dental Coverage
Deductible
Dental Deductible (Individual) $25
Dental Maximum Out of Pocket (Individual) $350
Dental Deductible (Family) $75
Dental Maximum Out of Pocket (Family) $700
Routine Dental Services (Adult) No Charge
Basic Dental Care (Adult) 50% Coinsurance after deductible
Major Dental Care (Adult) 50% Coinsurance after deductible
Adult Orthodontics Not Covered
Dental Check-Up for Children No Charge
Basic Dental Care (Child) 50% Coinsurance after deductible
Major Dental Care (Child) 50% Coinsurance after deductible
Orthodontia (Child) Not Covered
Premium Rates
Premium Child Age 0-14 27
Preimum Child Age 18 27
Premium Adult Individual Age 21 18
Premium Adult Individual Age 27 19
Premium Adult Individual Age 30 20
Premium Adult Individual Age 40 23
Premium Adult Individual Age 50 28
Premium Adult Individual Age 60 34
Premium Couple 21 36
Premium Couple 30 40
Premium Couple 40 47
Premium Couple 50 56
Premium Couple 60 68
Couple+1 child, Age 21 63
Couple+1 child, Age 30 67
Couple+1 child, Age 40 74
Couple+1 child, Age 50 83
Couple+2 children, Age 21 90
Couple+2 children, Age 30 94
Couple+2 children, Age 40 101
Couple+2 children, Age 50 110
Couple+3 or more Children, Age 21 117
Couple+3 or more Children, Age 30 122
Couple+3 or more Children, Age 40 128
Couple+3 or more Children, Age 50 137
Individual+1 child, Age 21 45
Individual+1 child, Age 30 47
Individual+1 child, Age 40 50
Individual+1 child, Age 50 55
Individual+2 children, Age 21 72
Individual+2 children, Age 30 74
Individual+2 children, Age 40 77
Individual+2 children, Age 50 82
Individual+3 or more children, Age 21 99
Individual+3 or more children, Age 30 101
Individual+3 or more children, Age 40 104
Individual+3 or more children, Age 50 109
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/
  • What You Should Know about Provider Networks. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://marketplace.cms.gov/outreach-and-education/what-you-should-know-provider-networks.pdf
  • Dental coverage in the Marketplace. U.S. Centers for Medicare & Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/coverage/dental-coverage/