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  • 2025 Dental Blue 65 Preventive
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    2025 Dental Blue 65 Preventive

    Take a proactive approach to protecting your dental health with the Dental Blue 65 Preventive plan. The plan covers 100% of preventive and diagnostic services, with no waiting period or calendar year maximum or deductible.

    As a Dental Blue 65 Preventive plan member, you’ll have access to a network that offers 93% of practicing local dentists and over 520,000 provider locations nationwide.

    Update

    $26.23

    Monthly Premium

    Enroll Now Enroll Now

    2025 plans are no longer available

    Dental Plans 2025
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    2025 Dental Blue 65 Preventive

    Monthly Premium

    $26.23

    Enroll Now Enroll Now

    Quick access to cost & benefit details

    Dental Covered
    Services
    Enhanced Dental
    Benefits
    Enrollment
    Options
    Forms &
    Documents

    Plan Highlights

    Cost & Copay
    Premium Per Month
    Premium Per Month
    $26.23
    Calendar Year Maximum
    Calendar Year Maximum
    $0
    Deductible
    Deductible
    $0
    Benefit Highlights
    • Pays 100% of preventive covered services.
    • Enhanced Dental Benefits for at-risk members with qualifying medical conditions
    Your Doctors

    Find out if your doctor accepts this insurance plan. Create a doctor list. Then, see which doctors are in network by selecting this link and opening the Doctor Coverage Section.

    Add Doctors

      Dental Covered ServicesSee information about covered services

      My Doctors (Details)

      Use our Check Doctor Coverage tool to see if your dentist is in network. If you’re looking to check coverage for an out-of-state dentist, use our Find a Doctor tool and select the Dental Blue network. With our Dental Blue 65 plans, you may see an out-of-network doctor outside of Massachusetts, but it may cost more. In Massachusetts, you can only see an out-of-network dentist for covered emergency services.

      Add Dentist

      Additional Doctor Coverage details for this plan

      My Doctors (details)

      Use our Check Doctor Coverage tool to see if your dentist is in network. If you’re looking to check coverage for an out-of-state dentist, use our Find a Doctor tool and select the Dental Blue network. With our Dental Blue 65 plans, you may see an out-of-network doctor outside of Massachusetts, but it may cost more. In Massachusetts, you can only see an out-of-network dentist for covered emergency services.

      Add Dentist

      Use our Check Doctor Coverage tool to see if your dentist is in network. If you’re looking to check coverage for an out-of-state dentist, use our Find a Doctor tool and select the Dental Blue network. With our Dental Blue 65 plans, you may see an out-of-network doctor outside of Massachusetts, but it may cost more. In Massachusetts, you can only see an out-of-network dentist for covered emergency services.

      Coverage Details for Dental Services

      Dental Covered Services

      Diagnostic Services: No Waiting Period
      • One complete initial oral exam, including initial dental history, and charting your teeth and supporting structures (gums, bones) to evaluate their condition
      • Full mouth X-rays (seven or more films), or panoramic X-ray with bitewing X-rays, once every 60 months
      • Additional bitewing X-rays once every six months
      • Periodic or routine oral exams 3 times in a calendar year
      • Emergency exams
      • Single tooth x-rays as needed
      • Study models and casts used in planning treatment once every 60 months
      Preventive Services: No Waiting Period
      • Routine cleaning, scaling, and polishing of the teeth 3 times in a calendar year
      • No waiting period for routine preventive services
      Basic Services: Available after six month waiting period *
      Not Included
      Major Services: Available after 12 month waiting period *
      Not Included

        Enhanced Dental BenefitsLearn about enhanced dental benefits included in this plan

        Enhanced Dental Benefits

        Enhanced Dental Benefits
        • Enhanced Dental Benefits offer full coverage for condition-specific preventive and periodontal services connected to improve the health of at-risk members. (Periodontal Services are only available on plans that cover periodontal services). Waiting periods still apply.
        • Enhanced Dental Benefits are included in the plan at no additional cost. These services aren’t subject to a deductible, co-insurance, or annual maximum.

          Enrollment OptionsView enrollment options like online, phone or paper

          Ways To Enroll

          Online Enrollment

          You can enroll at any time throughout the year.

          Enroll Online

          2025 plans are no longer available

          Call Consumer Sales

          Call 1-888-995-2583 (TTY: 711)
          8:00 a.m. to 8:00 p.m. ET,
          4/1 - 9/30, Mon. – Fri.
          10/1 – 3/31, 7 days a week

          Enrollment Form

          Dental Blue 65 Enrollment Form

          Mailing Address

          Consumer Sales
          Blue Cross Blue Shield of Massachusetts
          Enrollment Department
          P.O. Box 55011
          Boston, MA 02205

          Enroll through Fax

          Fax 1-617-246-8506

            Forms & DocumentsAccess key documents like enrollment forms and summary of benefits

            Important Plan Details and Information

            Enrollment Forms

            Dental Blue 65 Enrollment Form

            General Plan Document

            Dental Blue 65 Outline of Coverage

            Enhanced Dental Benefits Fact Sheet

            Enhanced Dental Benefits Enrollment Form

            Eligibility Information

              Enrollment Eligibility RequirementsReview qualification requirements for enrollment

              You're eligible to enroll if you meet all of the following requirements:

              • Age 65 or older.
              • Resident of Massachusetts.

              Get to know your Medicare options

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              Medicare Basics

              Get answers to your Medicare questions, including “Am I eligible?”.

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              Medicare Supplement Plans

              Medical-only plans with no copays or referrals. Add to prescription drug or dental plans for full coverage.

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              Find a Dentist

              See if your current dentist is part of our network or choose a new dentist that it.

              Find a Dentist
              Plan Disclaimers
              • This information is not a complete description of benefits. Call 1-888-741-4340 (TTY: 711) for more information.
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                PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag 1-800-472-2689 (TTY: 711).

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                お知らせ:日本語をお話しになる方は無料の言語アシスタンスサービスをご利用いただけます。ID カードに記載の電話番号を使用してメンバーサービスまでお電話ください 呼び出す 1-800-472-2689(TTY: 711)。

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                ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen 1-800-472-2689 (TTY: 711).

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                BAA !KOHWIINDZIN DOO&G&: Din4 k’ehj7 y1n7[t’i’go saad bee y1t’i’ 47 t’11j77k’e bee n7k1’a’doowo[go 47 n1’ahoot’i’. D77 bee an7tah7g7 ninaaltsoos bine’d44’ n0omba bik1’7g7ij8’ b44sh bee hod77lnih call 1-800-472-2689 (TTY: 711).

                Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross and Blue Shield Association. ® , ® , TM, SM Registered, Service, and Trade Marks are the property of their respective owners. © 2024 Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.

                Blue Cross Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities that have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. The joint enterprise is a Medicare-approved Part D Sponsor. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 

                You can file a complaint if you feel that you received inaccurate, misleading or inappropriate information. Please call Member Service at 1-800-200-4255 (TTY users call: 711). If your complaint involves a broker or agent, be sure to include the name of the broker/agent when filing your complaint.

                Y0014_24100_M_2025 | S2893_2432_2025 | Last Updated: 10/01/2024