When it comes to choosing the right dental insurance plan in California, there are quite a few things that need to be considered. For instance: Do you urgently require insurance benefits? Are you acquiring a plan mainly to keep up with your preventive care? Do you need an orthodontic treatment? Would you want to continue with your current dentist?
Urgency and Insurance Type
If you are in urgent need of dental benefits, especially right after your effective date, then you may need to acquire an HMO plan. They usually have shorter waiting periods, and you are given all the major services whenever you require them. HMOs typically don’t have benefit maximums.
For instance, if your child urgently requires braces-related help and you don’t have an insurance policy, if you acquire an Anthem Blue Cross stand-alone “Dental Premier Select HMO” or a Delta Dental “Delta Care USA” you’ll get the orthodontic benefit for a reasonably less price if you didn’t have a plan. If you acquire a PPO plan, it is more obvious that there would be a lack of orthodontic benefits, and even if there are, you will need to wait for one complete year.
Moreover, if you require root canals or extraction or a dental crown, there’s a possibility that you could have a three, six or even twelve month waiting period prior to the utilization of those services, plus the final bill could be much higher. For this reason, you should also ensure that you have a high benefit maximum, or you don’t have one at all. Hence it is always better to get HMO coverage if you don’t have coverage and require major benefits urgently.
Preventive Care and Orthodontics
If you are only looking to continue your preventive care, it is better to carry on with the low benefit maximum plans. You can always get an HMO plan in the future if you require major work.
Continuing with your Current Dentist
If you want to continue with the current dentist, but you are unhappy with your insurance coverage, then you should go for a PPO plan. Typically your dentist is not included in an HMO plan, and also in some PPO plans. Therefore, it’s ideal to get services from a local agent, and let him/her search for suitable contracted providers in your area. If your dentist isn’t a part of the networks that you are interested in, then you should seek out a new plan. You should be able to find a good dentist in your area if applying for a PPO plan. On the other hand if you are acquiring an HMO plan, you can still get a good dentist, but you will have less providers to select from.
Dental coverage can be confusing for many people to understand. This can sometimes deter individuals from purchasing a plan. However, it is extremely important to maintain the health of your teeth, otherwise, this can impact your overall health; leading to serious medial problems. Blue Shield of California is constructed to abolish this confusion and ensure that dental coverage is something that everyone can acquire with confidence.
Simplicity:
- You know exactly what you will pay upfront, so there are no hidden fees or surprises. This is extremely helpful when you are factoring your monthly or yearly medical costs into your budget.
- The premiums you do pay out of pocket are reasonable and inexpensive.
- Blue Shield of California’s dental plans are stand alone. This means you don’t have to be on a medical policy to apply for one!
- You will have access to one dental PPO and one dental HMO. This eliminates any confusion or frustration when trying to locate a dentist.
Advantages:
- You have access to a vast network of dentists and dental specialists.
- There is no waiting period for diagnostic and preventative services.
- Orthodontic benefits are available to both adults and children.
- You will be charged a minor – or no deductible – each calendar year, depending if you use a PPO or HMO dentist.
Value:
- After only two preventative visits, your plan is basically paid for. Each visit thereafter will cost you less than if you didn’t purchase any insurance coverage at all.
Ease:
- Blue Shield of California makes your monthly budgeting easier by giving you the option to combine both your medical and dental premiums together into one monthly statement.
We have mentioned PPO and HMO several times, but what exactly are they? These are two different groups available to access medical and dental care.
PPO (Preferred Provider Organization)
With a PPO plan, you are permitted to visit any dentist you wish – and there are over 19,000 in California to choose from. Although there is a list of preferred dentists, you will still receive coverage if you visit one outside of the network. A worthwhile benefit to a PPO is that your out of pocket expenses are lower then you seek out a dentist within our network. Although your premiums through PPO plans are usually more than through an HMO, you have more flexibility and fewer restrictions.
HMO (Health Maintenance Organization)
With an HMO plan, your costs – including premiums and out of pocket expenses – will be lower than if you opt for a PPO. You will also have no deductible on selected services. An HMO is more restrictive than a PPO however. You must visit a dentist that is listed on their directory; you will have a choice of approximately 8,600 dentists. If you instead choose to obtain services from a non-network facility, you will receive no coverage.
Everyone has different and unique needs when it comes to dental care, so the decision between these two plans is ultimately up to the individual.
Choosing a dental care plan in California can a very daunting task. With so many dental care plans offered by health maintenance organizations (HMOs), preferred provider organizations (PPOs), and health insurance agencies, choosing one that meets the your needs and that of your other family members can be very confusing. Let us help you in this endeavor by stating the top 5 reasons why should consider the Dental Blue Plans from Anthem Blue Cross of California.
1. You will get access to more than 21,000 dentists – You read it right! By enrolling in any of the four Dental Blue Plans, you can get dental care from more than 21,000 primary and specialty dentists all over California. To search for a primary or specialty care dentist go to anthem.com/ca and click “check the online provider directory.” The link should be located in the middle/right of the page. You are also welcome to contact us here at J.C. Lewis Insurance Services and we can supply you with a directory of dentists located in your area. There is never an extra fee for our services. Many people actually prefer an Insurance Agency like J.C. Lewis because you get to speak to someone live anytime wish. With large insurance companies there may be long wait times and multiple departments. With J.C. Lewis as your broker, you have only one department along with faster service. Similar to DSL Internet versus Cable modems and fast T1 lines:)
2. No deductibles to pay — As long as you use a dentist or dental specialist within the Dental Blue network, you don’t need to pay any deductibles for
teeth cleanings, dental exams and dental X-rays. As long as you pay your monthly premium these services will come to you free of charge.
3. Monetary Savings — All Dental Blue plans provide 100% coverage for the following preventive and diagnostic services: cleanings, dental exams, dental X-rays and dental sealants. Of course, this is under the assumption that you will be using a dentist within the Dental Blue network. Under the Dental Blue 100 Basic plan you will be able to get a negotiated savings for major services even though the plan says they aren’t covered. That’s right! Services such as oral surgery, endodontics, and prosthodontics will be covered at the negotiated savings while using a Dental Blue provider.
4. No waiting periods while using the Dental Blue 100 Basic plan– Once Anthem Blue Cross Life and Health Insurance Company has approved your policy, you can start using your Dental Blue 100 Basic plan to avail of basic and major dental services. If you are just looking to have preventive care options with coverage for your basic fillings and crowns then you found the right plan. There are no waiting periods so you can begin to use your plan immediately.
5. Coverage available now – If you are eager to begin you preventive dental health then you can apply today and be effective on a good, affordable dental plan within 1 week. You will have to allow some time for the processing of the paper work but once that is finished you can begin making appointments after you find a provider that sounds appealing. If you already have a provider in mind it’s important to make sure they accept the coverage. With over 21,000 providers in the state of California there is a good chance that they will accept the coverage.
