Benefits for Members of Group Plans

All Blue Dental^SM plans feature a comprehensive benefits package. The standard Blue Dental benefits package includes coverage from the following categories of benefits:

• Check ups and teeth cleaning
• Cavity repair and tooth extractions
• Root canals
• Gum and bone diseases
• High-cost restorations
• Dentures and bridges
• Orthodontics (optional)

Blue Dental also offers the following enhanced benefits, many of which are not available with other dental plans:

• Limited coverage for dental implants
• Guided tissue regeneration
• Periodontal splinting
• Standard benefit maximums of at least $1500
• Sealants and space maintainers covered at 100% for most plans

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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota. Blue Cross®, Blue Shield®, and the Cross® and Shield® symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.