Blue Cross Blue Shield FEP Dental Brochure - 2023

 
 
 
Blue Cross Blue Shield FEP Dental
Section 4 Your Cost for Covered Services
 
Annual Benefit Maximum
 
Once you reach this amount, you are responsible for all additional charges. The Annual Benefit Maximums within each option are combined between in and out-of-network services. The total Annual Benefit Maximum will never be greater than the In-Network Maximum Annual Benefit.

Maximum Annual Benefits:
In-Network High Option: Unlimited
In-Network Standard Option: $1,500
Out-of-Network High Option: $3,000
Out-of-Network Standard Option: $750