Pre-65 Insurance / Not HCTC Eligible
Total cost includes Medical, Prescription Drug, Dental and Vision Benefits
Blue Vision benefits are provided by Vision Service Plan (VSP), the largest provider of vision care in the nation. VSP is an independent company providing vision benefit services for Blues members. To find a VSP doctor, call 1-800-877-7195 or log on to the VSP Web site at vsp.com.
Note: Members may choose between prescription glasses (lenses and frame) or contact lenses, but not both.
Dental Benefits Summaries
The Airline Trust provides dental insurance coverage through Blue Cross Blue Shield
Enrolling in a Dental Plan
Dental insurance is offered through Blue Cross Blue Shield. This plan provides nationwide coverage and has both in and out of network coverage for plan participants. If you qualify for HCTC benefits, and you enroll in the Gold, Silver or Bronze Bundled Plans, your dental and vision coverage is already included. HCTC plan participants will pay 27.5% of the cost of their healthcare plans as long as the plans are priced as one cost( bundled). You also have the option of selecting the plan as a standalone plan paying 100% of the cost for you and your family members of all ages, including those members of your family on Medicare. There will be an admin fee of $4.25 of you and/or your family members select the dental coverage as a standalone plan.
To enroll in a dental plan only, you will need to complete, sign and date the enrollment form and return it to the Benistar Retiree Service Center.
Network Access information
With Blue Dental PPO Plus, members can choose any licensed dentist anywhere . However, they'll save the most money when they choose a dentist who is a member of the Blue Dental PPO network.
Blue Dental PPO network- Blue Dental members have unmatched access to PPO dentists through the Blue Dental PPO network, which offers more than 260,000 dentist locations nationwide. PPO dentists agree to accept our approved amount as full payment for covered services - members pay only their applicable coinsurance and deductible amounts. Members also receive discounts on noncovered services when they use PPO dentists (in states where permitted by law). To find a PPO dentist near you, please visit www.mibluedentist.com or call
1 Blue Dental uses the Dental Network of America (DNoA) Preferred Network for its dental plans.
2 A dentist location is any place a member can see a dentist to receive high-quality dental care. For example, one dentist practicing in two offices would be two dentist locations.
Blue Par SelectSM arrangement- Most non-PPO dentists accept our Blue Par Select arrangement, which means they participate with the Blues on a "per claim" basis. Members should ask their dentists if they participate with BCBS before every treatment. Blue Par Select dentists accept our approved amount as full payment for covered services - members pay only applicable coinsurance and deductibles . To find a dentist who may participate with BCBS, please visit www.mibluedentist.com.
Note: Members who go to nonparticipating dentists are responsible for any difference between our approved amount and the dentist's charge.