Our BlueMedicare Value plan includes dental coverage designed
with your health and budget in mind.
Take advantage of your dental benefits
Original Medicare doesn’t cover typical dental services, but your
BlueMedicare plan does—it covers regular dental checkups that
help your dentist find problems before they require major, costly
dental procedures.
The quality you expect from Blue
Florida Blue Medicare is your trusted partner for your medical
and dental health. We have the local expertise to ensure that our
networks include only dentists credentialed to meet Florida Blue
Medicare’s high standards.
What’s included with your BlueMedicare plan
Coverage for dental services, including:
• Dental cleanings
• Dental X-rays
• Oral exams
• Simple and surgical extractions
• Dentures and denture adjustments
• Nonsurgical periodontics
• Fillings
• Crowns
• Root canals
Getting care
You can find an in-network dentist at
floridabluedental.com/find-a-dentist.
Be sure to select your BlueMedicare
plan from the drop-down list of plans
and let your dentist's oce know
that your plan is in the Medicare
Advantage Dental Network.
BlueMedicare Value
Dental benefit summary
If you need assistance, you
can reach our member service
team Monday-Friday from
8 a.m. to 8 p.m. Eastern time.
1-888-223-4892
(TTY: 1-800-955-8770)
Member service
You may get care from the dentist of your choice, but there are no out-of-pocket costs or annual dollar
maximums for any covered services when you visit a dentist in our network. We negotiate discounted prices
with dentists in our network; if you use more dental services than your plan covers, you will be charged the
discounted negotiated rates. Check your Evidence of Coverage (EOC) for full details. You can find your EOC
in your My Health Link
TM
member portal on floridablue.com/medicare.
Where this plan is available
BlueMedicare Value is available in Alachua, Bay, Brevard, Broward, Calhoun, Charlotte, Citrus, Clay, Collier,
Duval, Escambia, Flagler, Franklin, Gadsden, Hernando, Highlands, Hillsborough, Indian River, Jeerson, Lake,
Lee, Leon, Liberty, Manatee, Marion, Martin, Miami-Dade, Nassau, Okaloosa, Orange, Osceola, Palm Beach,
Pasco, Pinellas, Polk, Santa Rosa, Sarasota, Seminole, St. Johns, St. Lucie, Sumter, Volusia, Wakulla, and
Walton counties.
23D-FB-1184
Y0011_115879 2023_C
1
All benefits are not available on all plans. Services not covered include: fillings; crowns; endodontics (root canals); periodontics (deep cleanings); dentures (complete or
partial). For a complete list of covered services, see your Evidence of Coverage.
2
Based on data published by FAIR Health, the largest independent health care claims data repository in the U.S. Retrieved from fairhealth.org (2023, August).
3
In network only. If you receive services from an out-of-network dentist (not in the Medicare Advantage Dental Network), you will need to pay your dentist up
front, and we will then reimburse you 55% of the nonparticipating rates.
Health coverage is oered by Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue, an Independent Licensee of the Blue Cross and Blue Shield Association.
We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex.
Visit floridablue.com/ndnotice for information on our free language assistance services.
©2023 Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. All rights reserved.
Oral Health for Overall Health
Our unique Oral Health for Overall Health
SM
program provides members with eligible medical conditions with
additional dental benefits that can help improve overall health.
Covered services
1
Number of services covered
in a calendar-year period
Market
rate
2
You pay
3
Preventive
Periodic oral evaluation (exam) 2 total $66 $0
Comprehensive oral evaluation (exam) 1 per lifetime, per dentist $123 $0
Bitewing X-rays (1-4 images) 1 set $83 $0
Intraoral—complete mouth X-rays or
panoramic image
1 set per 36 months $198 $0
Dental cleaning 2 total $113 $0
Comprehensive
Fluoride treatment 2 total $60
$0
Periodontal root planing (deep cleanings) 1 per quadrant per 24 months $367
$0
Full mouth debridement 1 per 36 months $249 $0
Fillings 2 total $356
$0
Root canal 1 total $1,296 $0
Crown
1 (only in conjunction with a
covered root canal procedure)
$1,500 $0
Extractions (simple & surgical) 4 total $249 $0
Dentures (complete or partial) 1 set per 60 months $2,112 $0
Denture adjustment 1 total $116 $0
Denture repairs 2 total $231 $0
Two additional
preventive visits
Periodontal scaling
covered 100%
Cancer screenings;
fluoride treatments
Chronic obstructive pulmonary disease, coronary artery
disease, diabetes, end-stage renal disease, metabolic
syndrome, pregnancy, and stroke
Oral, head, and neck cancers and Sjögren’s syndrome