is a great choice if you’re
looking to save money. With three options,
you can choose from a plan that covers only
the basics (like cleanings) to plans that
cover more in-depth services. With all plans,
you'll have access to more than 12,500 general
dentists and specialists in California and
more than 63,500 nationally.
Emergency
palliative treatment (emergency treatment of
dental pain)
Not
covered Not
covered
80%80%
80%
80%
Complex
and major services *
Endodontic
therapy (root canals)
Not
covered Not
covered
50%50%
50%
50%
Periodontal
(gum) services
Not
covered Not
covered
50%50%
50%
50%
Complex
oral surgery (includes root removal, treatment
of abscess)
Not
covered Not
covered
50%50%
50%
50%
Major restorative
services (replacing natural teeth)
Not
covered Not
covered
Not
coveredNot
covered
50%
50%
Prosthetic
services (dentures, partials and bridges)
Not
covered Not
covered
Not
coveredNot
covered
50%
50%
Prosthetic
repairs
Not
covered Not
covered
Not
coveredNot
covered
50%
50%
Deductible
Deductible
per person - applies to all eligible services
None
None
$50$50
$50
$50
Plan maximum
Annual
plan payment maximum per person (this is the
annual amount we'll pay for your covered dental
services)
$500
$500
$1,000$1,000
$1250
$1250
* Waiting periods may apply. Please View Plan Details
for more information.
NOTE
These policies DO NOT include coverage of pediatric
dental services as required under the Affordable
Care Act. Addition of the Pediatric Essential Health
Benefit is in process and is currently pending regulatory
review and approval.
This Benefit Comparison Table has been simplified
so you can easily compare plans. Some of the covered
services in the chart have limitations or exclusions,
such as limits as to how often you can get them
done. And there are some other terms you should
know about. Please see the product detail page and
the Dental Benefit Policy for full details. Claim
payments are based on the amount charged by the
dentist or our allowable charge, whichever is less.
If a non-network dentist charges more than our allowable
charge, the patient is responsible for the difference.
Costs and benefits stated above are based on
the rates and benefits in effect on your coverage start
date. Today's date is 12/19/2013.
Preferred Provider Organization (PPO) Plans
The PPO Plans offer you the most flexibility
in your
choice of doctors and hospitals (providers). PPO Plans
provide coverage (at different levels) for services from
both Participating and Non-Participating Providers.
Please see the PPO Plan section of this brochure for
definitions of these and other terms related to PPO Plan
Coverage. blu cross
Health Maintenance Organization (HMO) Plans
The Blue Cross of California HMO Plans
cover more of
the costs of your health care than any other plan type.
HMO Plans provide coverage only for services received
from doctors and hospitals within the HMO Network.
You choose a specific health care group and physician
within the network to coordinate all of your health care
needs.
Make the The Power of Blue work for you. Subscribe now
to Anthem
Blue Cross
More Services at No Additional Cost:
As a Blue Cross member, you'll also enjoy special member services,
including: HealthyExtensionsSM program, which gives our members information
about discounts offered by independent vendors on health & wellness
products & services that promote a healthy lifestyleMedCall®,
which offers 24/7 confidential access to registered nurses & information
from an audio library via toll-free phone callsHealth management programs,
which help our members & their physicians manage chronic diseases,
including diabetes, asthma & congestive heart failure
Oleg Skurskiy Authorized Independent Agent for Anthem Blue Cross (in California),
Anthem Blue Cross and Blue Shield (in Colorado, Connecticut, Nevada and
New Hampshire) and Blue Cross Blue Shield of Georgia. Independent licensees
of the Blue Cross Blue Shield Association
Individual and Family plans