Dental Plans (HMO & PPO)

THE DENTAL HMO HAS UNLIMITED ANNUAL BENEFITS:

When considering a dental plan for yourself and or family, the first plan you should look at is an HMO dental plan, for one primary reason; it has unlimited annual benefits.

I can email you a list of network dentists in your area.

Any PPO plan you look at will typically have annual benefit limits between $1,000 to $1,500.  A crown or root canal will eat up these amounts in the first visit.  While an HMO will provide unlimited benefits throughout the year.

  • Implants – are covered with the Blue Shield Dental HMO.
  • All Ages – are able to enroll with the Blue Shield Dental HMO plans.
  • Rates are at the bottom of this chart:

ANTHEM – has several Dental plans to choose from; PPO, HMO, individuals, seniors and group dental plans for employees.

Most of the Anthem plans are for Under-age 65. Anthem Extras PPO is for the 65 and older person.

If you are under age 65 and want dental insurance for yourself or family, the Anthem Dental Prime PPO is the plan to look at. Also available is the Dental Select HMO, which you can view below.

Age 65 and above, then the plan is Anthem Extras, which is a Dental PPO plan with the option to add Vision coverage as well.

All Dental plan are “stand-alone” plans which means you can enroll in a dental plan by itself, no need for other Anthem products.

  • PPO Dental = massive local, state and national networks to freely move around.  Most likely your dentist is contracted with a Dental PPO.
  • HMO Dental = a fraction of the price and with unlimited annual benefits.  Although you are not allowed to move freely among network dentists. If you change a dentist or dental office, the effective change typically starts the first of the next month.

How does a PPO Dental Plan work?  Most PPO dental plans allow you to move freely to any dentist, in-network or out.  Although the plan will pay much more if you see a contracted in-network dentist.

First, the total bill will typically be reduced by 25% to 40% depending on the service provided, because of the network contracted dental rates.  Instead of a crown costing $1,200, the plan rate may be $850, then the insurance pays 50% of that which equals $420.

PPO Dental plans provide flexibility, allowing you to see different dentists within a PPO dental network.  Most PPO plans will say you can see any dentist, in or out of the network, although is is very important to stay within the network of dentists, because you will see the greatest savings when going to a contracted dentist.

29,000 Contracted locations in California

Most dentists will tell you they accept “All” ppo’s.  This may be true, but the problem with this statement is; if the dentist accepts the plan but is not a contracted dentist for the plan you are enrolled, the amount the plan pays to an “out of network dentist” is greatly reduced.  Always try to see an “in-network” dentist, you’ll pay less.

Anthem Dental Prime PPO (Under age 65)

DENTAL PRIME RATES:

Waiting Periods:  All PPO dental plans will have some sort of waiting period for “Basic” services along with “Major” services.  If you have dental insurance from another company or employer group plan, the new plan will honor the previous coverage and typically waive your new waiting periods.

If you are in a waiting period, you will still see impressive costs savings of 25% – 40% simply by seeing a network PPO dentist.  Because they are bound by the company and plan contracted and negotiated service fees.  Also, over 87,000 contracted dental offices nationwide.

Anthem HMO Dental Select:

(UNDER AGE 65)  With an HMO Dental plan your will need to choose a dentist or dental office when you enroll.  This will be your dental office for all of your dental services. You will not have freedom of choice with different dentists with an HMO plan.  Although your out of pocket amounts will be less with an HMO plan, typically copays for the different dental procedures.

The Anthem HMO dental plan does not have a 12 month waiting period for “major” services.  View the Anthem Dental Brochure for more info.

Anthem Senior Dental PPO (ages 65 & above):

Anthem Extras Dental plans, you do not need other Anthem insurance to enroll in one of these dental and or  vision plans. These are “stand-along” plans.

Anthem Blue Cross has the same quality PPO dental plans with optional vision coverage called Anthem Extras, which can compliment all of our Medicare Supplement plans.  Anthem Extras consist of three packages; Standard, Premium and Premium Plus.  All three offer valuable benefits and services.

Anthem Senior PPO Dental & Vision:

Please feel free to reach out to me by phone (916) 682-1117 or email at john@johnconner.com or simply complete the brief information request form below.

John Conner
916-682-1117
john@johnconner.com

Questions & Comments:

Author: John

Medicare Options along with Individual and Group International Medical Insurance Options.