Your Blue Cross and Blue Shield of New Mexico (BCBSNM) plan includes dental care for eligible members. Dental care is administered through DentaQuest®*. It is important to use these benefits to keep your teeth healthy. Find helpful tips for healthy teeth on DentaQuest's website. Check out "Oral Health Tips and Education."
Finding a Dentist
Do you need to find a dentist in your area? Or do you want to confirm if a dental treatment needs prior authorization? Call Member Services at 1-866-689-1523.
If you have special needs, Member Services can help you. Examples:
- Need to know handicap accessible offices
- Need to know languages spoken by a dentist
You can also search for dentists on DentaQuest's website.
What services are covered?
Many dental services are covered when you see an in-network provider:
- Preventive dental care – oral exams, cleanings, x-rays, topical application of fluoride, sealants
- Restorative dental care – fillings and crowns
- Orthodontia – braces for eligible members under 21 years old
Dental benefits can vary depending on your age. Check the Member Handbook for a list of covered services.
What services are not covered?
BCBSNM does not cover certain dental services such as cosmetic dentistry, tooth bleaching, and implants. Check the Member Handbook for a list of non-covered services.
Dental Emergency
Most dental problems are not "emergencies." An emergency means the dental problem is life-threatening. Examples of a dental emergency:
- Broken tooth
- Knocked-out tooth
- Toothache with swelling (possible infection)
If you have a dental emergency, call your dentist.
Urgent Dental Care
An urgent dental problem is when you need to be seen the same day, but it isn't serious enough to go the ER. You should be seen within 24 hours for urgent dental care. If you cannot find a dentist to see you within 24 hours, call Member Services.
Non-Urgent Dental Care
A non-urgent dental problem is when you have symptoms but don't need to see a dentist the same day. Non-urgent dental problems should be seen within 14 days.
Routine Dental Care
Routine care is a regular dental check-up. Or it's a dental condition that is not causing problems or pain. You should be seen within 60 days of your request for routine care. If your dentist cannot see you within 60 days, call Member Services.
Prior Approval for Dental Care
Some dental care requires prior approval. You must have approval before getting treatment. Call for approval before your appointment. For more information, check the Member Handbook. Or call Member Services.
Questions?
Call Member Services at 1-866-689-1523.
*Blue Cross and Blue Shield of New Mexico dental care services are administered by DentaQuest.