Anthem BlueCross BlueShield
Essential Choice Classic
Our newest Essential Choice PPO plans – good for individuals or families – give you five options to choose from to help save money on dental case. You can have coverage for popular services, such as teeth whitening, implants, and child orthodontics. All five of these plans cover tooth-colored fillings on back teeth.
Essential Choice Classic PPO – covers all of the services covered by Essential Choice Silver Plan, with lower out-of-pocket costs for basic services; and has a higher annual maximum benefit of $1500.
| Common procedures: | |
|---|---|
| Cleaning: | 100% |
| White Filling: | 80% |
| Crown: | 50% |
| Root Canals: | 50% |
| Simple Extractions: | 80% |
| Plan Maximum: | $1500 |
| Waiting Periods: | Preventive-None, Basic-3 month, Major-6 month |
| Deductible: | $50 per person, up to $150 per family. Deductible is waived for diagnostic and preventive services in network only |
| Details: |
|---|
| Fee Schedule: N/A | Dentist Search | Exams: |
| Routine periodic examinations - Once in a 6 months period In Network: 100% Out-of-Network: 80% after deductible Preventive - No waiting period | Cleanings: |
| Teeth Cleanings - Once in a 6 months period In Network: 100% Out-of-Network: 80% after deductible Preventive - No waiting period | X-Rays: |
| Diagnostic and Preventive x-rays: bitewing, periapical In Network: 100% Out-of-Network: 80% after deductible Preventive - No waiting period | Fillings: |
| In Network: 80% after deductible Out-of-Network: 60% after deductible Basic - 3 month waiting period | Extractions: |
| Simple Extractions In Network: 80% after deductible Out-of-Network: 60% after deductible Basic - 3 month waiting period | Crowns: |
| In Network: 50% after deductible Out-of-Network: 50% after deductible Major - 6 month waiting period | Root Canals: |
| In Network: 50% after deductible Out-of-Network: 50% after deductible Major - 6 month waiting period | Dentures: |
| In Network: 50% after deductible Out-of-Network: 50% after deductible Major - 6 month waiting period | Deep Cleanings: |
| In Network: 50% after deductible Out-of-Network: 50% after deductible Major - 6 month waiting period | Implants: |
| Not Covered Service | Braces/Orthodontia: |
| Not Covered Service | Teeth Whitening: |
| In Network: 50% after deductible Out-of-Network: 50% after deductible Major - 6 month waiting period | Additional Network Information: |
Choice of dentists While your dental plan lets you choose any dentist, 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.” PPO Plans not available in all states. Exclusions and Limitations: N/APrivacy Policy Plan Brochure |
FAQ:
Can I change my dentist once I am in the plan?
Yes, this is a Preferred Provider Organization (PPO) plan and you can change dentists at any time.
What is a pre-existing condition versus work-in-progress? Is it covered?
Dental services completed prior to the date that the policy takes effect are not covered. Basic and Major Services (if applicable) have waiting periods. Teeth that are missing prior to the effective date of the policy may have an additional waiting period for replacement services. It is recommended, but not required, that a pretreatment estimate be submitted prior to treatment for major restorative, periodontal, or prosthodontic services. The pretreatment estimate is a valuable tool that helps both you and your dentist know what benefits are available to you before receiving dental care.
What provider options do I have?
You may see any licensed dental provider that you would like. However, your out-of-pocket costs will be lower when you go to a provider who participates in our Dental Prime network.
When can I start using my Plan?
Your plan takes effect the first of the month after we receive your completed application. Basic and Major Services (if applicable) have waiting periods. If you have different dental coverage that this policy is replacing, you may be eligible to have that prior coverage count toward your waiting period.
When will I receive my new member kit and what will it include?
Within 7-10 days of completed enrollment, you will receive your ID cards and information about how to register online.
Who can enroll in this plan?
To be a policyholder, you must be a resident within the state or service area where this plan is available and must be at least 18 years of age. Eligible dependents can also be covered under this policy.
Disclaimers and Disclosures:
This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.
Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.
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