Blue Cross Blue Shield of Michigan offers this marketplace health insurance plan (Plan ID 15560MI0710001) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Michigan). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Low Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
Variant 15560MI0710001-00 (Standard Off Exchange Plan) currently displayed.
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Benefits
Covered services & limitations
Pregnancy & family
Maternity, newborn, pediatric dental and vision extras.
Basic Dental Care - Child
40.00% Coinsurance after deductible
Tier 1 in-network40.00% Coinsurance after deductible
Out-of-network40.00% Coinsurance after deductible
Limit: 1.0 Procedure(s) per 3 Years
Sealants - 1x per permanent molars, every 3 years. Fillings - 1x per 24 months for primary teeth, 1x per 48 months for permanent teeth. Periodontal maintenance - 3x per calendar year in combination with routine prohylaxis (cleaning). Simple extractions - 1x per lifetime per tooth. Root canals - 1x per lifetime per tooth. Pediatric members are defined as members age 18 or younger when their coverage begins. For plans with a deductible, please reference the Plan Brochure for deductible details.
Exclusions: nan
Major Dental Care - Child
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1.0 Procedure(s) per 2 Years
Scaling and root planing - 1x per quadrant, per 24 months. Onlays, crowns, veneers - 1x every 60 months. Bridges and dentures - 1x every 84 months. Implants - not covered. Pediatric members are defined as members age 18 or younger when their coverage begins. For plans with a deductible, please reference the Plan Brochure for deductible details.
Tier 1 in-network40.00% Coinsurance after deductible
Out-of-network40.00% Coinsurance after deductible
Emergency palliative treatment for temporary pain relief
Exclusions: 6-month waiting period waived for emergency palliative treatment. Benefit only applies to MOOP for pediatric members. Pediatric members are defined as members age 18 or younger when their coverage begins.
Basic Dental Care - Adult
40.00% Coinsurance after deductible
Tier 1 in-network40.00% Coinsurance after deductible
Out-of-network40.00% Coinsurance after deductible
Limit: 2.0 Procedure(s) per Year
Periodontal maintenance - 2x per calendar year in combination with routine cleaning (3rd is covered for members with adverse medical condition). Sealants - not covered. Fillings - 1x per 24 months for primary teeth, 1x per 48 months for permanent teeth. Simple extractions - 1x per lifetime per tooth. Root canals - 1x per lifetime per tooth. Members age 19 or older when their coverage begins are considered non-pediatric. For plans with a deductible, please reference the Plan Brochure for deductible details.
Exclusions: 6-month waiting period on Class II services for members age 19 and older when their coverage begins, except for sealants and emergency palliative treatments.
Dental Check-Up for Children
20.00%
Tier 1 in-network20.00%
Out-of-network20.00%
Limit: 2.0 Procedure(s) per Year
Prophylaxis (Cleaning) - 2x per calendar year. Exams - 2x per calendar year. Bitewing X-rays - One set (up to 4) per calendar year. Fluoride - 2x per calendar year. Pediatric members are defined as members age 18 or younger when their coverage begins.
Exclusions: nan
Major Dental Care - Adult
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1.0 Procedure(s) per 3 Years
Scaling and root planing - 1x per quadrant, per 36 months. Onlays, crowns, veneers - 1x every 60 months. Bridges and dentures - 1x every 84 months. Implants - not covered. Members age 19 or older when their coverage begins are considered non-pediatric. For plans with a deductible, please reference the Plan Brochure for deductible details.
Exclusions: 12-month waiting period on Class III services for members age 19 and older when their coverage begins. Implants are not covered.
Orthodontia - Adult
Coverage details pending
nan
Exclusions: nan
Orthodontia - Child
Coverage details pending
nan
Exclusions: nan
Routine Dental Services (Adult)
20.00%
Tier 1 in-network20.00%
Out-of-network20.00%
Limit: 2.0 Procedure(s) per Year
Prophylaxis (Cleaning)- 2x per calendar year (3rd is covered for members with adverse medical condition). Exams - 2x per calendar year. Bitewing X-rays - One set (up to 4) per calendar year. Fluoride - Not covered. Members age 19 or older when their coverage begins are considered non-pediatric.
Exclusions: nan
Variant attributes
Blue Dental PPO Plus 80/60/50 · Variant 15560MI0710001-00
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard Low Off Exchange Plan
HIOS Product ID
15560MI071
Metal Level
Low
Plan ID (Standard Component ID with Variant)
15560MI0710001-00
Plan Marketing Name
Blue Dental PPO Plus 80/60/50
Plan Variant Marketing Name
Blue Dental PPO Plus 80/60/50
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
15560
Issuer Marketplace Marketing Name
Blue Cross Blue Shield of Michigan Mutual Insurance Company
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
Yes
Network ID
MIN007
Out of Country Coverage
Yes
Out of Country Coverage Description
Emergency
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
Any licensed dentist in the US can participate in the Tier 2 par per claim Blue Par Select arrangement. Similar to PPO, dentists accept Blue Cross' approved amount for covered services as payment in full, less deductible or any coinsurance.
Service Area ID
MIS004
State Code
MI
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out
Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group
$850 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$425 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$425
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual
Begin Primary Care Cost-Sharing After Number Of Visits
0
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
No
Dental Only Plan
Yes
EHB Apportionment for Pediatric Dental
1.0
First Tier Utilization
100%
Import Date
2024-08-14 20:01:41
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
Existing
Medical EHB Deductible, Combined In/Out of Network, Family Per Group
$225 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person
$75 per person
Medical EHB Deductible, Combined In/Out of Network, Individual
$75
Medical EHB Deductible, In Network (Tier 1), Family Per Group
$225 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person
$75 per person
Medical EHB Deductible, In Network (Tier 1), Individual
$75
Medical EHB Deductible, Out of Network, Family Per Group
$225 per group
Medical EHB Deductible, Out of Network, Family Per Person
$75 per person
Medical EHB Deductible, Out of Network, Individual
$75
Plan Effective Date
2025-01-01
Plan Level Exclusions
$1,000 annual benefit maximum for members age 19 or older when coverage begins.
Plan Type
PPO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
15560MI0710001
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Michigan?
Blue Dental PPO Plus 80/60/50 (15560MI0710001) is a Low PPO from Blue Cross Blue Shield of Michigan in Michigan for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Blue Dental PPO Plus 80/60/50 support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is Blue Dental PPO Plus 80/60/50 HSA-eligible and does it include dental or vision coverage?
HSA eligibility is not published; check the Summary of Benefits or ask the issuer.
Dental add-ons: Adult, Child.
Vision coverage is not listed for this plan.
Does Blue Dental PPO Plus 80/60/50 support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Is there out-of-country coverage for Blue Dental PPO Plus 80/60/50?
Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Emergency
Does Blue Dental PPO Plus 80/60/50 cover care outside the service area?
Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Any licensed dentist in the US can participate in the Tier 2 par per claim Blue Par Select arrangement. Similar to PPO, dentists accept Blue Cross' approved amount for covered services as payment in full, less deductible or any coinsurance.
How do I enroll in or manage payments for Blue Dental PPO Plus 80/60/50?
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
