Dental plan options for Medicare Supplement clients
Looking for ways to give your clients more choices with more plans? Look no further than Blue Shield's dental plans for Medicare Supplement plan members. Your clients can save $3 each month for the first six months on their dental plan rates if they enroll in a dental plan at the same time they enroll in any Blue Shield Medicare Supplement plan.
For details, please refer to the following dental plan charts.
| Effective July 1, 2024 | DPPO 1500 | DPPO 1000 | ||
|---|---|---|---|---|
| Monthly premium | $56.10 | $37.40 | ||
| Calendar-year deductible (per member) |
$50/person | $75/person | ||
| Calendar-year maximum | $1,500 ($1,000 may be used for non-network dentist)1 |
$1,000 ($750 may be used for non-network dentist)1 |
||
| Service | With network dentist | With non-network dentist2 Blue Shield pays: |
With network dentist | With non-network dentist2 Blue Shield pays: |
| Diagnostic and preventive care (not subject to plan deductibles with network dentists; includes an oral cancer screening, routine oral exams, X-rays, and three annual cleanings | 100% | 80% | 100% | 50% |
| Basic services (includes anesthesia, palliative treatment, and restorative dentistry) |
80% | 70% | 50% | 50% |
| Major services3 12-month waiting period Dental PPO 1500 and 6-month waiting period for Dental PPO 1000 (All plans include crown buildups, endodontics, periodontics, oral surgery, crowns, prosthetics, inlays, onlays, jackets, posts and cores, and veneers. |
50% | 50% | 50% | 50% |
| Dental implant services |
Included: Coverage for over 30 dental implant services | Not Included | ||
These charts are only summaries. For more information regarding the Dental PPO 1000 and Dental PPO 1500, please refer to the applicable Evidence of Coverage/Health Service Agreement.
Our dental plans offer extensive networks
With a Blue Shield dental PPO, your clients can have the freedom to choose any provider they want, but will save more when they choose a provider in their plans extensive network of nearly 46,000 general and specialty-care dentists in California, and nearly 350,000 nationwide.4
Dental Plan enrollment details
- Dental coverage can be added for both existing and new Medicare Supplement plan members.
- Effective dates can be on any day of the month except days 29 through 31.
- Instruct your client to complete a short dental enrollment application and return it to us; no underwriting is required. If your client is requesting waiting periods to be waived, they must submit proof of prior coverage that includes major dental coverage and other required documentation.
- Once enrolled, your client will receive one bill combining their medical and dental premiums.
Enrollment forms and information
Visit Arvato Storefront and use your Broker Connection credentials to find all of the materials you need to help enroll your clients in one of Blue Shield’s dental plans for Medicare Supplement plan members.
Visit our Help Medicare Supplement Clients page to find all of the materials you need to help your clients who are already enrolled in a Blue Shield dental plan for Medicare Supplement plan members.
1 Each calendar year, the member is responsible for all charges incurred after the plan has paid these amounts for covered dental services.
2 The indicated coinsurance percentage is a percentage of allowed amounts that we pay to providers. Non-network providers can charge more than our allowable amount. When members use non-network providers, they must pay the applicable copayment/ coinsurance plus any amount that exceeds our allowable amount. Charges in excess of the allowable amount do not count toward the calendar-year deductible or copayment maximum.
3 Dental PPO 1500 plan members have a 12-month waiting period, and Dental PPO 1000 dental plan members have a 6-month waiting period for major restorative services and procedures (such as crowns, endodontics, periodontics, oral surgery, and removable or fixed prosthetics). The waiting period may be waived with proof of prior comprehensive coverage.
4 Dental providers in and out of California are available through a contracted dental plan administrator.
The company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability. La compañía cumple con las leyes de derechos civiles federales y estatales aplicables, y no discrimina, ni excluye religión de manera diferente a las personas por su raza, color, país de origen, identificación con determinado grupo étnico, condición médica, información genética, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad, ni discapacidad física ni mental. 本公司遵守適用的州法律和聯邦民權法律，並且不會以種族、膚色、原國籍、族群認同、醫療狀況、遺傳資訊、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡、精神殘疾或身體殘疾而進行歧視、排斥或區別對待他人。
Page last updated 10/01/2024
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