Dental Coverage Frequently Asked Questions


Do members need their BCBSNM member ID card when they visit the dentist?

Yes, it's always a good idea for them to have their BCBSNM member ID card with them. To confirm their coverage with us, the dentist may call our Customer Service at 1-877-723-5697.

What are the advantages of using BCBSNM's in-network providers?

In-network dentists agree to file claims for our members and accept members' coinsurance and the balance of our fee allowance as payment in full for covered services. While our members may receive their dental care from any licensed dentist (no referrals are necessary), receiving dental care from one of our in-network dentists provides significant savings and less paperwork for the member.

In-network dentists are reimbursed directly by BCBSNM, so members only pay their coinsurance and do not have to file claim forms. Members usually pay the full amount for services received from an out-of-network provider and file a claim form. Then reimbursement is automatically sent to the member, unless we are directed in writing by the member to send reimbursement to the out-of-network provider.

Are there any waiting periods for dental services?

No. Dental services are available to members when they become eligible for coverage through their employer. For example, some employers provide benefits on the date of hire, while others make benefits available on the first of the month following your date of employment.

What do members do if their employer changes dental insurance carriers when they are in the middle of treatment?

If the date a member started treatment is before the carrier change, then the former carrier will provide benefits for covered services. Orthodontic services are an exception to this rule. If the new carrier provides orthodontic benefits, they will provide benefits for the remaining services, up to the benefit limit.

If the current carrier provides up-to-date utilization information for each member and the full deductible has been satisfied, the member will be credited for the deductible. Any benefit payment made by the carrier is charged against the member's annual maximum. If this utilization information is not provided for all members, a new deductible would need to be satisfied.

Learn More About BlueCare Dental PPO for Groups: