Web124. 2024 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option. Section 5 (g). Dental Benefits. Page 124. Basic Option Dental Benefits. Under Basic Option, we provide benefits for the services listed below. You pay a $30 copayment for each evaluation, and we pay any balances up to the Maximum Allowable Charge (MAC; … WebEnrollment process. Follow these four steps, and you’ll be on your way to coverage with BlueCare, meaning you can focus on just living life. 1. Review and compare plans. 2. …
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WebBlue Cross and Blue Shield . FEP Service Benefit Plan Basic Option (111, 112 or 113) Effective January 1, 2024 Maximum Allowable Charge (MAC) Under Basic Option, we provide benefits for the services listed below. The member pays a $30.00 copayment per evaluation. For all other covered dental services, FEP pays 100% of WebNationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self: ... 9.83: 737.69: 763.52: 593.48: 170.04: 9.17: Nationwide Blue Cross and Blue Shield Service Benefit Plan Basic Option - Basic Self Plus One: 113: 682.73: 706.63: 524.65: 181.98: 10.37: 682.73: 706.63: 546.21: 160.42: 9.82: Nationwide Blue Cross and Blue ... can have mine
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