Hidden Value in PPO Dental Plans…

Anthem Blue CrossDental Blue Brochure

Stand alone dental plans… What are they?  Well a stand alone dental plan is simply a dental plan that you can apply for that does not require you to also have the medical component.  Not all companies offer a dental plan that you can apply for by itself.

Anthem Blue Cross offers a PPO dental plan called “Dental Blue”.  This dental plan is available for both individuals and families.  Like the Anthem Blue Cross medical plans, the dental PPO plans offer an extensive network of providers and you can if you choose seek dental care outside the network.

Anthem offers two dental plans to choose from, Dental Blue Basic and Dental Blue Enhanced.  The Basic plan provides coverage for many diagnostic services and preventive care such as cleanings, exams and X-rays, as well as filling, with an annual maximum of $500 per member.

The Dental Blue Enhanced plan includes cleanings, exams, X-rays and fillings – plus certain major services like root canals, periodontal procedures and crowns, with an annual maximum of $1,250 per member.  It also includes orthodontic coverage for children after a 12 month waiting period.

Now all this sounds great but many people I speak with point out the low annual maximums.  This is what they focus on until they have an opportunity to explore further the benefits of  a dental plan.  A unique feature of Dental Blue is that members have access to the rates Anthem has negotiated with providers during any applicable waiting periods, after the annual maximum has been met, and for certain non-covered services like veneers, dental implants and TMJ treatment.  Mind you however these discounts are available only at in-network providers.

In addition, as a member you can see any dentist you want; however, you do have the potential for lower costs when you choose a dentist in the Dental Blue 100 network.  Like the medical side the in-network dentists have agreed to accept Anthem’s fee schedule for services rendered.  If you go outside the Dental Blue network, you can be billed the difference between what Anthem would pay their in-network dentists and what your chosen dentist wished to charge.

Let me share with you a recent example of how the hidden value of having a dental plan pays off in a big way.  I received a phone call from a lady in Southern California who had an immediate need of two crowns.  The dentist she had gone to had quoted her $1,100 per tooth.  She called me and she wanted to know how long the waiting period was for major services and I told her 12 months.  She was very clear that she did not want to wait the 12 months before the benefits would kick in.

I explained to her that even though she had not met her waiting period she would still benefit from the negotiated discounts as long as she selected a dentist within the Anthem network.  It just so happen that the dentist she had selected was also an Anthem provider.  Although I could not tell her what the savings would be if she enrolled – I was sure it would be substantial enough to make the enrollment cost worth it to her.  So she enrolled.

A couple of weeks later she called me to tell me that the dentist did the crown work on both teeth and when she was all done she paid $550.00 per tooth.  This was a savings of $1,100.00 just by using a network provider.  Once enrolled she also was able to utilized the preventive care part of the dental plan as well.  So the monthly fee of $46.00 was more than paid for by the savings between the retail charge quoted and the final network amount she paid.

This is just one example of the hidden value that stand alone dental plans can offer.  The buying power of an organization such as Anthem is huge.  So in addition to the plan benefits – the savings can be even greater thus making the Dental Blue PPO plan a good buy.  If you want to find out more about the Anthem Dental Blue PPO plan visit our webpage here. 

Applying for Dental Blue (or should I say enroll) is easy to do.  Anthem now allows you to apply online and choose your effective date.  If you apply online you can request an effective date as soon as tomorrow.  One more thing about these plans – people seem to really like them as they tend to keep them for many years.