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Anthem, also known as Anthem Blue Cross or Anthem Blue Cross Blue Shield, is one of the nation’s best-known insurers, offering a variety of health coverage through several different brands. Taken together, Anthem brands represent one of the largest health benefits providers in the United States. While widely known for their health insurance products, Anthem also has a robust selection of specialty insurance plans which includes dental coverage. Anthem dental insurance products cover Americans across the country and the company boasted total dental membership of over six million people for the year 2020. Anthem’s dental products can be purchased either individually by consumers or by businesses for group dental plans.
Anthem’s presence in the dental market extends beyond consumers. Their Dental Provider Savings Program provides discounts up to 40% to dentists on office devices such as scanners and personal protective equipment, lab services (implants, clear aligners, dentures), and dental telemedicine technology. Anthem has also upgraded their online portal for dentists to submit their patients’ claims as well as verify patient insurance eligibility for specific services before they are performed.
Anthem was named by Fortune Magazine as the #1 Most Admired Company within the Health Care Provider segment in 2020. In the same year, the Anthem Foundation announced that it had committed $50 million to COVID-19 response and recovery efforts. These efforts include provisions for the safety of health care providers, mental & behavioral health support resources, and resources to combat food insecurity.
A popular line of dental products from Anthem is the Essential Choice. The plans in this line include the Essential Choice Incentive, Essential Choice Bronze, Essential Choice Silver, Essential Choice Gold, and Essential Choice Platinum. All five of these plans are PPOs. PPO stands for “preferred provider organization.” A PPO has the lowest out-of-pocket costs for covered services among in-network dentists but still allows an enrollee to seek treatment out-of-network (albeit at higher costs).
The entry-level of these options is the Bronze. It has the lowest premium among Essential Choice plans and has no waiting periods before preventive care such as annual teeth cleaning and oral exams that can be received by an enrollee. Unlike other Essential Choice plans, the Bronze does not have any coverage for major dental work such as root canals or crowns. In contrast, other Essential Choice plans provide major dental coverage (usually with a waiting period). The deductible on the bronze plan varies by the number of enrollees. For a single person, it has a $50 deductible. Each additional enrollee within a family plan is another $50 deductible but the family deductible is capped at a maximum of $150 a year. This deductible is waived for diagnostic and preventive services if they are received in-network.
The Silver plan is the next entry in the Essential Choice insurance line. While many of its out-of-pocket costs are similar to the Bronze plan, it includes coverage for major dental services like crowns in contrast to the Bronze plan. This coverage for major dental work becomes active six months after enrollment. This delay is known as a “waiting period.”
The Gold plan has a 50 percent higher plan maximum than either the Bronze or Silver plans. The plan will pay covered dental expenses costing up to $1,500 in a single year. The plan also has lower out-of-pocket costs for some services as compared to either Bronze or Silver plans.
The Platinum plan, while having a higher monthly premium than the Bronze, Silver, and Gold plans, has attractive out-of-pocket costs for services as well as a $2,000 annual plan maximum.
The Platinum plan also includes orthodontic coverage for children through age 18. This coverage has a maximum lifetime benefit of a $1,000 for qualified orthodontic care and a $150 lifetime deductible for these services.
The Essential Choice Incentive PPO has the highest plan maximum within the product line. The plan will spend up to $2,500 annually on covered dental services. In comparison, the Bronze and Silver plans have a $1,000 plan maximum. The plan also includes rewards for enrollees who receive preventive care according to plan guidelines. Practically, this means that an enrollee’s out-of-pocket costs for fillings, crowns and other selected services are lower in the second and third year of coverage so long as the enrollee has at least one preventive care dental visit annually.
As was the case for the Platinum plan, the Incentive plan has orthodontic coverage for children under age 19. After satisfying a $150 orthodontic deductible, this coverage has a maximum lifetime benefit of a $1,000 for qualified orthodontic care.
No waiting periods. Increasing benefits. Coverage for implants and orthodontia.
Plan Type: PPO
Plan Maximum: $2000
Coverage includes dental implants and orthodontia for children.
Plan Type: PPO
Plan Maximum: $2000
Comprehensive plan with coverage for major services.
Plan Type: PPO
Plan Maximum: $1000
Are you interested in getting cosmetic dentistry but you're uncertain if it will be covered by your dental plan? The Plan Details page for each dental insurance option will summarize what the plan covers as well as differences in in-network/out-of-network costs for the patient. On the Plan Details page you can see if the below cosmetic procedures are covered, what the out-of-pocket obligations are for a patient, and if there are any waiting periods associated with the service:
For a more detailed treatment of this subject, see Cosmetic dental insurance.