Dental Plans for Individuals Families and Employees

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

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.

Individual & Family Dental Plans:

PPO, HMO and Fixed Benefit plans  –  You will always pay less with a quality  dental plan for yourself, children or family.

  • 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 dental network size, and you are not able to freely move to different dental offices, although the plans typically do not have waiting periods for many services.

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.

HMO Dental Select Plan:

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.

Individual, family and employee dental plan which can be started anytime of the year.  PPO’s, HMO’s and fixed benefit plans which allow you to see any dentist and receive a specific benefit amount mailed to you for the dental procedures provides.  Dental Plan Info

You will typically pay much more for an out-of-network dentist

Your plan lets you choose any dentist, whether or not that dentist is part of our network. But you may end up paying more for a service if you visit an out-of-network dentist.

Here’s why: In-network dentists have agreed to payment rates for various services and cannot charge you more. On the other hand, out-of-network dentists don’t have a contract with us and are able to bill you for the difference between the total amount we allow to be paid for a service – called the “maximum allowed amount” – and the amount they usually charge for a service. When they bill you for this difference, it’s called “balance billing.”

Big Savings with a PPO dental:

  • Crown  –  Dentist price = $1,200
  • Cash price = $950
  • PPO Insurance price = $850

Then the insurance coverage pays an additional 50% of the insurance price, which equals $425.

Senior Dental (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 call anytime with questions.

John Conner

Questions & Comments:

Author: John

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