Blue Cross Blue Shield FEP Dental Brochure - 2023

Blue Cross Blue Shield FEP Dental
Summary of Benefits
Summary of Benefits
  • Do not rely on this chart alone. This page summarizes your portion of the expenses we cover; please review the individual sections of this brochure, for more detail.
  • If you want to enroll or change your enrollment in this plan, please visit or call 1-877-888-FEDS (1-877-888-3337), TTY number 1-877-889-5680.
  • Out-of-Network services under Classes A, B and C are subject to a $50 deductible per person under High Option and a deductible of $75 for Standard Option per person per calendar year.
  • For children age 13 and under, you pay $0 for In-Network Class B and Class C covered services as defined by the plan subject to plan maximums.