Anthem Blue Cross Dental PPO plans Compared Side by Side

Anthem Blue Cross Dental Prime for Individuals and Families

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The benefits listed below as example only. To view updated benefits click on view rates

Anthem Blue Cross Dental Prime for Individuals and Families 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. Prime Plan A Prime Plan B Prime Plan C     Coverage Level   In Network Diagnostic and preventive services             Exams 100% 100% 100% 100% 100% 100% Cleanings 100% 100% 100% 100% 100% 100% X-rays 100% 100% 100% 100% 100% 100% Sealants 100% 100% 100% 100% 100% 100% Fluoride treatments 100% 100% 100% 100% 100% 100% Basic services  *              Amalgam fillings (silver) Not covered Not covered 80% 80% 80% 80% Space maintainers Not covered Not covered 80% 80% 80% 80% Basic tooth extractions Not covered Not covered 80% 80% 80% 80% Brush biopsy Not covered Not covered 80% 80% 80% 80% 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 covered Not covered 50% 50% Prosthetic services (dentures, partials and bridges) Not covered Not covered Not covered Not covered 50% 50% Prosthetic repairs Not covered Not covered Not covered Not 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.

Mail applications to:

Oleg Skurskiy
21781 Ventura Blvd # 1067
Woodland Hills, CA 91364or

By Fax 818-776-9865

More Dental plans for California residents

• Anthem Blue Cross Dental Blue PPO Individual and Family plans

• Anthem Blue Cross Senior Dental PPO

• Anthem Blue Cross Dental Saver Select HMO

• Anthem Blue Cross Dental Select HMO Individual and Family plans

• Anthem Blue Cross Dental Premier Select HMO

• Anthem Blue Cross Senior Dental Select HMO

• PacifiCare Signature Value Dental 160 HMO $15.50 up Individual and Family plans

Oleg Skurskiy
Authorized Independent Agent
Phone: 818-987-5000
Fax: 818-776-9865
Request Assistance

License 0E50389