Dental Prime and Dental Complete Plans
With our new Dental Prime and Dental Complete plans, 14 different areas of the plan can be customized, including:
| Choice of annual maximums and deductibles |
| Choice of out-of-network reimbursement options – either a percentile of FAIR Health ranging from the 50th to the 90th percentile, or a MAC fee schedule|
| Choice of frequency of coverage for bitewing X-rays – either once every 12 months or twice every 12 months|
| Optional coverage for:|
Composite (tooth-colored) fillings on all teeth
Brush biopsy benefits. A brush biopsy may help diagnose oral cancer when combined with lab analysis and a surgical biopsy with lab analysis.
An extra cleaning or periodontal maintenance procedure each year for members who are pregnant or living with diabetes
Orthodontic coverage for children only or children and adults
Annual maximum carryover, which allows members to carry over some unused benefits to the next year
Dental Prime and Dental Complete plans offer our customers an outstanding network value, with two great dental networks to choose from:
| The Dental Prime contracted network, our deep-discount network |
| The Dental Complete contracted network, our larger network|
Dental Prime and Dental Complete members also have access to additional dental providers through our participation in the National Dental GRID, a national dental network by and for participating Blue plans. The National Dental GRID includes dentists in all 50 states and provides multi-state customers with a truly national solution with in-network discounts across the country.
Access to the GRID networks is provided by the GRID Dental Corporation, a separate company.
Dental Blue® Plans
These popular dental plans offer:
| More than 12,000 unique dentists and 22,000 access points to choose from in California|
| Diagnostic and preventive services like cleanings, exams and X-rays — at no cost when using an in-network provider on most dental plans|
| Fillings at 80% (or even 90%) when using an in-network provider|
| More extensive services like oral surgery, crowns and root canals|
| Riders are available for:|
Orthodontic benefits for adults and/or children
Annual maximum carryover
Brush biopsies to screen for oral cancer
Posterior composite fillings
| Combined administration with other Anthem plans|
Dental Blue members receive our negotiated rates on covered services even after they have reached their policy’s annual maximum or if frequency limitations have been exceeded for a covered service. For instance, if a dental plan covers two cleanings a year and the member wishes to have a third cleaning, they would receive our negotiated rates for the third cleaning.
Plus, members who are pregnant or living with diabetes covered by our group-based Dental Blue plans receive an extra cleaning or periodontal maintenance procedure (for healthy teeth and gums) each year. This does not count toward their annual maximum. That's because good dental health may have an impact on the control of diabetes and may assist in controlling the effects that hormonal changes during pregnancy can have on gum health.
Dental Net® DHMO Plans
Our Dental Net DHMOs have:
| No annual maximums1 or deductibles|
| No waiting periods|
| Low or no copays for nearly 300 different services, including:|
-Cleanings, exams and X-rays
-Composite (tooth-colored) fillings on any tooth
-Orthodontic services for both children and adults
| 8,000 general dentist and specialist access points throughout California|
Choice Dental Plans
Our Choice Dental plans offer the perfect balance between the choice offered by a dental PPO plan and the cost control of a DHMO plan.
| They allow members to switch between a dental PPO and a DHMO at the beginning of each month|
| Their pricing falls between Dental Net and Dental Blue PPO plan pricing|
| They are available in most California counties where Anthem Blue Cross is licensed to offer Dental Net DHMO plans|
Voluntary Dental Plans
Our new Dental Prime and Dental Complete plans can be offered on a voluntary basis so employees can get more coverage—at no extra cost to their employer. Employees get the advantage of group rates instead of more costly individual plan rates. And, in some cases, they get more benefits than individual plans offer. Plus, at least five enrolled employees need to be maintained to offer these voluntary plans.
International Emergency Dental Program
All Anthem dental members and their eligible, covered dependents automatically have access to the International Emergency Dental Program managed by DeCare Dental.2 With this program, members may receive emergency dental services through our list of credentialed, English-speaking dentists while traveling or working nearly anywhere in the world.