DENTAL PLAN BLUE CROSS BLUE SHIELD OF MA DENTAL BLUE FREEDOM Benefits begin on June 1st but dental benefits are provided In-Network on a calendar year basis Annual Deductible $50 member / $150 family maximum Annual Maximum Benefits $1,500 / year per person PreventiveCare (Cleanings and Exams) 100% Coverage; deductible does not apply to preventive services Basic Care (Fillings, Extractions, etc.) 80%Coverage* MajorCare (Crowns, Implants, Dentures) 50%Coverage* Orthodontia 100% Coverage; deductible does not apply to orthodontia services Lifetime maximum of $2,000 per family member Accumulated MaximumRollover If your claims do not exceed $700 during the plan year, BCBS will rollover $500 towards your calendar year maximum to use next year and beyond. The rollover balance is capped at $1,250 *after deductible Benefits are reduced by 20 percent when services are received from an out-of-network dentist Dental Summary of Benefits 2024 Benefits Guide | 12