BlueCross & BlueShield of Oklahoma | ||
Network: DNoA Preferred | ||
Customer Service: 800 672 2567 | ||
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 |
$1,500 Lifetime Maximum | ||
50% Co-Insurance | ||
For Adults & Dependent Children up to Age 26 Only | ||
Not Deductible or Waiting Period |
Current & Former Employee Coverage & Rates for the 2025/26 Plan Year, effective 7/1/2025 through 6/30/2026. |
49.76 | Member | |||
26.30 | Child | |||
41.80 | Children | |||
61.46 | Spouse | |||
87.76 | Spouse & Child | |||
103.26 | Spouse & Children |