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Blue Choice

Summary of Preventive Dental Benefits

Preventive Dental is automatically included in most CarolinaADVANTAGE plans and covers an allowed amount per benefit period for exams and cleanings at any licensed dentist.

  • Preventive Dental, one exam: initial $27/periodic $20
  • Preventive Dental, one cleaning: adult $40/child $31

Send a completed Member Claim Form and the paid receipt from your dentist to BlueChoice HealthPlan. We will reimburse you for the allowed amount.

Please complete and send this form to:

BlueChoice HealthPlan
P.O. Box 6170
Columbia, S.C. 29260-6170