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Blue Dental PPO Extra 100/70/50
Healthcare.gov Individual Dental Plan Finder
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Blue Dental PPO Extra 100/70/50

Overview
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Blue Dental PPO Extra 100/70/50 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 Presque Isle 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
15560MI0720002
Coverage area
Presque Isle 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
$0
Out-of-Pocket Maximum
$350
Coverage
Adult Dental Coverage
Child Dental Coverage
Deductible
Dental Deductible (Individual) $0
Dental Maximum Out of Pocket (Individual) $350
Dental Deductible (Family) $0
Dental Maximum Out of Pocket (Family) $700
Routine Dental Services (Adult) No Charge
Basic Dental Care (Adult) 30% 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) 30% Coinsurance after deductible
Major Dental Care (Child) 50% Coinsurance after deductible
Orthodontia (Child) Not Covered
Premium Rates
Premium Child Age 0-14 32
Preimum Child Age 18 32
Premium Adult Individual Age 21 23
Premium Adult Individual Age 27 24
Premium Adult Individual Age 30 25
Premium Adult Individual Age 40 29
Premium Adult Individual Age 50 35
Premium Adult Individual Age 60 43
Premium Couple 21 46
Premium Couple 30 51
Premium Couple 40 59
Premium Couple 50 71
Premium Couple 60 86
Couple+1 child, Age 21 79
Couple+1 child, Age 30 84
Couple+1 child, Age 40 92
Couple+1 child, Age 50 104
Couple+2 children, Age 21 111
Couple+2 children, Age 30 116
Couple+2 children, Age 40 125
Couple+2 children, Age 50 136
Couple+3 or more Children, Age 21 144
Couple+3 or more Children, Age 30 149
Couple+3 or more Children, Age 40 157
Couple+3 or more Children, Age 50 169
Individual+1 child, Age 21 55
Individual+1 child, Age 30 58
Individual+1 child, Age 40 62
Individual+1 child, Age 50 68
Individual+2 children, Age 21 88
Individual+2 children, Age 30 91
Individual+2 children, Age 40 95
Individual+2 children, Age 50 101
Individual+3 or more children, Age 21 121
Individual+3 or more children, Age 30 123
Individual+3 or more children, Age 40 128
Individual+3 or more children, Age 50 133
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/