Free aids and services for people with disabilities to communicate effectively with us, such as: Written information in other formats (such as accessible electronic formats). UYUy>vcUbR!|ilJg 0 endstream endobj 19 0 obj <> endobj 20 0 obj <> endobj 21 0 obj <> endobj 22 0 obj <> endobj 23 0 obj [/DeviceN[/Cyan/Magenta/Black]/DeviceCMYK 53 0 R 55 0 R] endobj 24 0 obj <> endobj 25 0 obj <> endobj 26 0 obj <>stream An information system that incorporates membership data and provider reimbursement arrangements and analyzes transactions according to contract rules. 0000076164 00000 n Limited to once every 24 months for primary teeth, and once every 48 months for permanent teeth. 0000012877 00000 n 0000034533 00000 n The member's location at the time of service is irrelevant. BlueCare Dental HMOSM Voluntary Plan is a PPO that requires no employer contribution while still offering the employees the benefit of dental coverage in one of the largest dental PPO networks. 0000050197 00000 n Learn more about dental services for adult STAR members, 8 a.m. to 5 p.m. Central Time Monday through Friday. Understanding your Blue Cross Blue Shield FEP Dental coverage is the key to making the most of your benefits, keeping your smile healthy and protecting your overall health. BlueCare Dental Choice PPO - This is known as an active plan design. (Coverage is not available for non-network dentists in Massachusetts except for covered emergency services.) PDENT is your dental plan. HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Access theDental Wellness Center. Access educational information on a wide range of dental topics including pediatric care, prevention and dental treatments. 0000006097 00000 n Get access to your member portal. With BlueCare Dental PPO, members have the option to receive care from dentists who are not in the network. There is a deductible for Class II and III services only. Our BlueCare DentalSM program offers two network-based dental products. and Prevention (CDC), and state and local public health departments. 0000107898 00000 n Below are answers to some of the frequently asked questions. The site may also contain non-Medicare related information. Information that relates to an individual's past, present, or future physical or mental health or condition, or the past, present, or future payment for the provision of health care to an individual, including demographic information, received from or on behalf of a health care provider, health plan, clearinghouse, or employer, which either identifies the individual or could be reasonably used to identify the individual. A type of Health Benefit Plan that allows members to go outside the network for non-emergency care, but may result in a lower level of benefits being paid by the Health Benefit Plan. Pursuant to Section 1557 Blue Cross Blue Shield FEP Dental does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, age, disability, or sex (including pregnancy and gender identity). You pay 50% after deductible before meeting your out-of-pocket max, and $0 after meeting your out-of-pocket max. 0000007922 00000 n You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. This drug list is updated monthly. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Fully Insured Summary of Dental Benefits 2023 BlueCare Dental PPO (Small Group) Plans 0000041754 00000 n 0000049503 00000 n HVKH+Djj+r%VF9dje;!h]_gLP8a "&SDi^&=.k)VU_? |7 Pacific Blue Cross has available coverage for health, dental and emergency medical travel. Periodontal maintenance Children can get pediatric benefits until the end of the calendar year in which they turn 19. endstream endobj 8 0 obj <> endobj 6129 0 obj <> endobj 6130 0 obj <> endobj 838 0 obj <> endobj 2595 0 obj <>/K 1115 0 R/ParentTree 2597 0 R/ParentTreeNextKey 138/RoleMap 2695 0 R/Type/StructTreeRoot>> endobj 2596 0 obj <>/A0+1<>/A0_1<>/A1<>/A1+1<>/A1+2<>/A10<>/A10+1<>/A10_1<>/A11<>/A11+1<>/A11_1<>/A12<>/A12+1<>/A12+2<>/A12_1<>/A13<>/A13+1<>/A14<>/A15<>/A17<>/A2<>/A2+1<>/A2+2<>/A20<>/A3<>/A3+1<>/A4<>/A4+1<>/A4_1<>/A5<>/A5+1<>/A5_1<>/A6<>/A6+1<>/A6_1<>/A7<>/A7_1<>/A8<>/A8+1<>/A9<>/CM1<>/CM1+1<>/CM1+2<>/CM1+3<>/CM10<>/CM10+1<>/CM10+2<>/CM10+3<>/CM11<>/CM11+1<>/CM11+2<>/CM11+3<>/CM12<>/CM12+1<>/CM12+2<>/CM12+3<>/CM13<>/CM13+1<>/CM13+2<>/CM14<>/CM14+1<>/CM14+2<>/CM15<>/CM15+1<>/CM16<>/CM16+1<>/CM17<>/CM18<>/CM2<>/CM2+1<>/CM2+2<>/CM2+3<>/CM3<>/CM3+1<>/CM3+2<>/CM3+3<>/CM4<>/CM4+1<>/CM4+2<>/CM4+3<>/CM5<>/CM5+1<>/CM5+2<>/CM5+3<>/CM6<>/CM6+1<>/CM6+2<>/CM6+3<>/CM7<>/CM7+1<>/CM7+2<>/CM7+3<>/CM8<>/CM8+1<>/CM8+2<>/CM8+3<>/CM9<>/CM9+1<>/CM9+2<>/CM9+3<>/Pa0<>/Pa0+1<>/Pa0_1<>/Pa1<>/Pa1+1<>/Pa10<>/Pa10+1<>/Pa10_1<>/Pa11<>/Pa11+1<>/Pa11+2<>/Pa11_1<>/Pa12<>/Pa12+1<>/Pa12_1<>/Pa13<>/Pa13_1<>/Pa14<>/Pa14_1<>/Pa15<>/Pa15+1<>/Pa16<>/Pa16+1<>/Pa16_1<>/Pa17<>/Pa17_1<>/Pa18<>/Pa18_1<>/Pa19<>/Pa19_1<>/Pa2<>/Pa2+1<>/Pa20<>/Pa21<>/Pa21_1<>/Pa24<>/Pa25<>/Pa26<>/Pa28<>/Pa3<>/Pa3+1<>/Pa30<>/Pa4<>/Pa4+1<>/Pa5<>/Pa5+1<>/Pa5+2<>/Pa6<>/Pa6+1<>/Pa6_1<>/Pa7<>/Pa7+1<>/Pa7+2<>/Pa7_1<>/Pa8<>/Pa8_1<>/Pa9<>/Pa9+1<>/Pa9_1<>>> endobj 1115 0 obj <> endobj 2597 0 obj <><>]>> endobj 2695 0 obj <> endobj 2132 0 obj <>1036]/P 2131 0 R/Pg 997 0 R/S/Link>> endobj 2077 0 obj <>991]/P 2076 0 R/Pg 987 0 R/S/Link>> endobj 2033 0 obj <>990]/P 2031 0 R/Pg 987 0 R/S/Link>> endobj 2061 0 obj <>988]/P 2060 0 R/Pg 987 0 R/S/Link>> endobj 2212 0 obj <><>]/P 2211 0 R/Pg 972 0 R/S/P>> endobj 2580 0 obj <>1240]/P 2579 0 R/Pg 1008 0 R/S/Link>> endobj 1244 0 obj <>280 281 282]/P 1243 0 R/Pg 927 0 R/S/Link>> endobj 1242 0 obj <>263 264]/P 1241 0 R/Pg 927 0 R/S/Link>> endobj 1223 0 obj <>255 256 257]/P 1222 0 R/Pg 927 0 R/S/Link>> endobj 1211 0 obj <>167 168 169]/P 1210 0 R/Pg 910 0 R/S/Link>> endobj 1160 0 obj <>73]/P 1159 0 R/Pg 849 0 R/S/Link>> endobj 1159 0 obj <> endobj 849 0 obj <. Blue ShieldFEP Dental's value and offerings. 0000006892 00000 n trailer The Medicare component that provides benefits to cover the costs of physicians' professional services, whether the services are provided in a hospital, a physician's office, an extended-care facility, a nursing home or an insured's home. 0000002318 00000 n Although you can go to any dentist of your choice, your benefits under BlueCare Dental PPO Rider will be greater when you use the services of an in-network dentist. If you are a BCBSTX STAR member and you would like to receive or learn more about dental services for adults ages 21 and older, please call DentaQuest directly for assistance. Any dental plan offered by an organization that provides a benefit plan that differs from a traditional fee-for-service plan. Please refer to your Dental Benefit Booklet for additional benefit information. Sending a letter to Blue Cross Blue Shield FEP Dental, P.O. 0000003753 00000 n Limited to twice a year in combination with routine cleaning. 0000069257 00000 n Site Map|Feedback|Download Adobe Acrobat Reader, Learn more about a Healthier Michigan.org, Glossary of Health Coverage and Medical Terms, Important Information About Medicare Plans. BlueCare Dental is a portfolio of standard dental preferred provider option (PPO) benefit plan designs BlueCare Dental Freedom SM and BlueCare Dental Choice SM. Basic services like fillings and root canals. Unfortunately, Medicaid does not cover cosmetic dentistry procedures like veneers. BlueCare Dental Connection integrates dental care management and health care management with a focus on preventive care and individual involvement. Need help understanding and choosing a benefit plan? 2021 SUMMARY OF BENEFITS 0000088308 00000 n See also precertification. Preventive care like exams and cleanings. Traditional insurance, also known as Indemnity or Fee-for-Service, allows members to select any healthcare provider for services. Addresses the health and lifestyle needs of consumers through unique partnerships and experiences designed exclusively for Blue365 members. Implants coverage available Orthodontic benefits are available on select plans for both children and adults Up to $75 deductible per member, per calendar year Choice of a $1,000, $1,250 or $2,000 calendar-year benefit maximum per member Coverage even when members use a non-network dentist. %?Mf_A_a_A_a_A_a_A_e_E_YpV:+ To give you an accurate price, we'll need some information. Traditional insurance offers the most freedom of choice and control over healthcare, but benefits are maximized when using a participating Blue Cross Blue Shield company. The PPO dental plan provides a higher level of benefits when members receive treatment from BlueCare Dental participating providers. Important Legal and Privacy Information|Important Information About Medicare Plans|Privacy Practices xref 'on[/b,k"=|g/my6Johp!?yuv9R`LZM8eW$@'I#Z%%@CX2`A6*a)TtAMb?|,*+9 ?B%UFV)l)ypvwIH rtB!gvdPW;R13LmVDwfeLki]CxEb5n>OT|~_Yz[pw\;Oh1O70A|S|S? After reaching that limit for the year, you pay for 100% of your dental care. 0000006632 00000 n Cleanings are covered twice a year. Fillings and sealants. 0000047131 00000 n BHI brings together the healthcare experience of more than 54 million Blue Cross and Blue Shield members nationwide. Our AskBlue SM BCBS FEP Dental Plan Finder tool can help you select the right plan for your needs. A summary of benefits and coverage explains things like what a health insurance plan covers, what it doesn't cover, and what your share of costs will be. r9J2InHV`@Lb`\a%diF`3200h f`ig`` a In addition, some sites may require you to agree to their terms of use and privacy policy. Most PDF readers are a free download. Some examples are: (1) a provider who physically examines the patient, (2) a lab that performs the blood draw from a patient, or (3) a technician who fits a prosthetic limb to the patient. 0000010274 00000 n 0000039957 00000 n If the member elects to receive care from BlueCare Dental network providers: If the member elects to receive care from providers outside of the network, they may choose: In addition, members have access to the BlueCare Dental ConnectionSMprogram. Bitewing X-rays Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association NOT FOR DISTRIBUTION TO BENEFICIARIES, MEMBERS, OR PROSPECTS BlueCare Dental Classic Plans 1,2 BlueCare Dental Classic plans cover only one person per policy. Blue Cross and Blue Shield of Oklahoma (BCBSOK) is providing access to the Dental Wellness Center website as a courtesy, as part of its BlueCare Dental Connection program. X~ )T`2*>+;NC][i\3{- GWn.gr7NrYa?5*~'sfn:6hV-_b{. by: Nichole Niemann. 0000003118 00000 n 15 49 This new site may be offered by a vendor or an independent third party. The fee determined by an MCO (managed care organization) to be acceptable for a procedure or service, which the physician agrees to accept as payment in full. The program integrates dental care management and health care management with a focus on preventive care and individual involvement. 0000024004 00000 n PPOs have lost some of their popularity in recent years as health plans reduce the size of their provider networks and increasingly switch to EPOs and HMOs in an effort to control costs. We calculate our dental premiums based on your location (rating areas) and the plan option you select. hb```e`` l@Q>l e I#r^ Important Legal and Privacy Information |Important Information About MedicarePlans| Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, All-Ages Dental Certificate of Coverage (PDF), Important Information About MedicarePlans. The BlueCare Dental HMO network includes specialists such as oral surgeons, orthodontists, pediatric dentists, endodontists (specialists in diseases of the nerve within the tooth) and periodontists (specialists in diseases of the gums and tissues). Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. 0000017747 00000 n They are not balance billed Network providers will not bill for costs that are in excess of the BCBSTX allowable amount for covered services. Register Now, Not registered? For more information on specific coverage you can contact customer service. Blue Cross and Blue Shield of Texas (BCBSTX) covers emergency dental services your child gets in a hospital or ambulatory surgical center. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. An evaluation of the medical necessity, appropriateness and cost-effectiveness of healthcare services and treatment plans for a given patient. A specified dollar amount that a member must pay out-of-pocket for a specified service at the time the service is rendered. June 17, 2022 . Refer to this list for drug coverage information for Blue Cross members whose plan uses the Custom Select Drug List. The three characters preceding the subscriber identification number on BCBS member ID cards. You can buy this plan if you live in any Michigan county. 0000053119 00000 n The application of managed care principles (techniques to reduce costs and improve quality of heallthcare) to 24-hour coverage. The health plan physician executive who is responsible for the quality and cost-effectiveness of the medical care delivered by the plan's providers. 0000003587 00000 n BlueCare Dental HMO offers a dental network that is one of the largest in Illinois. Not registered? The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. A process in which a healthcare organization undergoes an evaluation of its operating procedures to determine whether the procedures meet designated criteria as defined by the accrediting body, and to ensure that the organization meets a specified level of quality. President of Blue Cross and Blue Shield of Texas The Dental Schedule of Coverage enclosed with this Benefit Booklet indicates benefit percentages, Deductibles, maximums, and other benefit and payment issues that apply to the Plan. Non-contracting dentists will charge employees their regular fee and may bill them for the balance not covered by the dental benefit plan. BlueCare Dental Connection integrates dental care management and health care management with a focus on preventive care and individual involvement. A healthcare system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee. Check out our Member Education Materials to get more information aboutBlue Cross Choose from a variety of affordable group health plans to fit the needs of your employees and your business. 0000139581 00000 n collect outside the U.S. BCBS FEP Dental has a larger nationwide network with nearly half a million provider access points. Your clients can choose the best dental plan(s) that meets the needs of their employees. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. We use cookies to ensure that we give you the best experience on our website. Class I services have no deductible. 0000070270 00000 n /E!{"I+e1m5 Ni!V4H b~G}.5]W=7)Rxk[L9S7)cb?4 01=G35`{uio)}li.\ Ne:~Mo)ccpsYSG#xE^-x9L)qEK,duLGJNek. Note: There will be no changes to coverage and claims details for existing Blue Choice plan holders following the new Health and Dental launch on . We will work with and follow all COVID-19 guidance and protocols provided by the Centers for Disease Control 0000002422 00000 n The three dental plans for children on Medicaid are: Dentaquest, MCNA Dental and UnitedHealthcare Dental. How can bcbstx Star members get help with dental services? All member-submitted claims must be received within two years of the date of service. It identifies the member's Blue Cross Blue Shield company or national account in order to properly route the claim. Also known as preventive care programs or wellness programs. Contact Pacific Blue Cross for more information or to speak with one of our Service Representatives: Individual Plans Sales and Support Telephone: 604 419 2000 Fax: 604 419 2199 Email: inhealth@pac.bluecross.ca Toll-free Outside the Greater Vancouver Area: BlueCare Dental ConnectionSM is a program benefit that provides members with education and intervention through support tools and educational mailings. +3. Blue Distinction Centers for Specialty Care, Need to Make a Payment? 0000049726 00000 n For personal medical guidance, please consult your dentist and/or physician. IV. Register Now, Not registered? 0000015051 00000 n A document that provides background information about various underwriting impairments and suggests the appropriate action to take if such impairments exist. Access Your Payment Options. BCBSIL assumes no liability or responsibility for damage or injury to persons or property arising from the use of any product, information, idea, or instruction contained on the Dental Wellness Center Web site; go2dental.com is solely responsible for the content and any advice given on its website. 0000029289 00000 n Patients and Blue Cross Blue Shield Arizona members can contact Blue Cross Blue Shield Arizona or its affiliated health plan using the phone number on the back of their insurance card with questions or reach out to memberhelp@azblue.com. For dental care, you can go to any licensed dentist and this plan will share the cost. Only members with this identifier can access the benefits of BlueCard PPO. Visit www.bcbsmt.com/member 2. %PDF-1.6 % 2020-09-09T21:17:19-07:00 The review and possible authorization of proposed treatment plans for a patient before the treatment is implemented. Our health plan advisors can help you choose a plan, calculate your costs and tell you whether you're eligible for a subsidy. All Rights Reserved. Use our Premium Finder to easily find your premium amount or take a look at the tables below to determine your premiums. Covered once per tooth per lifetime. The direct care provider should file claims to the local Blue Cross Blue Shield company. 0000050349 00000 n Not Registered? In addition, some sites may require you to agree to their terms of use and privacy policy. If you're not familiar with the health insurance terms used on a summary of benefits and coverage, here's a Glossary of Health Coverage and Medical Terms. The site may also contain non-Medicare related information. 0000075693 00000 n BlueCare Dental Connectionis a program benefit that provides members with education and intervention through support tools and educational mailings. The deductible is usually a set amount or percentage determined by the members contract and is set for a given period of time. To view this file, you may need to install a PDF reader program. Your coinsurance is your share of the costs of a service. Learn more about BCBS FEP Dental plan benefits and premiums. A free-standing center that performs various types of surgery. 0000017596 00000 n Provides greater healthcare transparency by delivering detail about healthcare trends and best practices, resulting in healthier lives and affordable access to safe and effective care. External link You are leaving this website/app (site). 44 0 obj <> endobj Your employer should be able to provide a benefit booklet for you which will provide some details of your coverage. Get access to your provider portal.Register Now, Not registered? The Medicare component that provides basic hospital insurance to cover the costs of inpatient hospital services, confinement in nursing facilities or other extended care facilities after hospitalization, home care services following hospitalization and hospice care.
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