Dental Blue

Dental Blue Healthy Supplement
Dental Blue Healthy Supplement is an optional dental plan with fitness and weight loss benefits for Service Benefit Plan members who live in Massachusetts.

Dental Blue Healthy Supplement works with the dental benefits in Standard Option and Basic Option. What does that mean for you? You get additional dental benefits for less cost. The advantages of this plan include:

• Coverage for preventive services and fillings

• Composite resin fillings (tooth color) on back teeth covered in full

• Network includes 90 percent of Massachusetts dentists

• Affordable premiums

• Plus a $150 Fitness Benefit and $150 Weight Loss Benefit

2012 Dental Blue Healthy Supplement at a Glance
2012 Dental Blue Healthy Supplement Brochure

To find out if your dentist is participating, visit www.bluecrossma.com.

How to Enroll
Print, complete (with signature), and mail the Dental Blue Healthy Supplement Enrollment Form to:

Blue Cross Blue Shield of Massachusetts
Dental Blue Healthy Supplement Enrollment Department
PO Box 55380
Boston, MA 02205-8338

Monthly premiums are billed directly to the subscriber. A convenient automatic electronic file transfer (EFT) payment option is available if you would like the premium deducted automatically each month from your checking account.

Electronic Fund Transfer (EFT) Brochure
Electronic Fund Transfer (EFT) Form

How to Get Reimbursed for fitness and weight loss
After you have been a member of a health club and Dental Blue Healthy Supplement for at least 4 months in a calendar year, you can download and submit the Fitness Benefit Form and receive up to $150 per calendar year toward your club membership.

After you have collected up to $150 in paid receipts from your qualified weight loss program, you can download the Weight Loss Benefit Form and file a claim for your Weight Loss Benefit. For complete instructions on how to get reimbursed for fitness and weight loss, download the 2012 Dental Blue Healthy Supplement Brochure.