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New Accounts - Provider | Member

BlueCross BlueShield South Carolina Dental

Blue Cross/Blue Shield of South Carolina

Avesis administers dental benefits to members of Blue Cross/Blue Shield of South Carolina Medicare Blue Saver and Medicare Blue Plans.

Below you will find an image of the ID card that members will present for services along with a description of the member's covered benefits.

id card

Office Visit Co-Pay: $10.00 per office visit

One per year (A or B):

  ADA Code Description Limitations
A D0120 Recall Exam One per year
B D0150 Comprehensive Exam One per year; (for new patients only-limited to one every 3 years)

One per year:

  ADA Code Description Limitations
A D1110 Cleaning ages 14 through adult One per year

Choose One per year (A or B or C):

  ADA Code Description Limitations
A D0270/D0272/D0273/D0274 Bitewing X-rays One set per year
B D0220 Single x-ray film and up to 3 additional
D0230
Total of 4 films per year
C D0210 Full Mouth X-rays One set per year; allowed one every 3 years;