Anthem Extras Dental PPO Sacramento

Over age 65 and looking for a solid PPO dental plan in Sacramento County?  Anthem offers a stand-alone ppo dental for anyone on Medicare.  You can also add Vision, Hearing and Silver Sneakers fitness program.  This package of products is called Anthem Extras.  Below is a brief look at the dental only plan.  For more details you can view the brochure which I have provided the link below the benefit chart.

Who is Eligible for Anthem Extra’s Dental Plan ..Anyone age 65 or older.  Anthem Extras Plans are considered “Stand-Alone” plans, which means you do not need an Anthem Medicare plan to enroll in Anthem Extras.  All you need to be is 65 or older, that’s it!!  Even if you have a Medicare Supplement plan from another company, Anthem Extras is for you!!  You can enroll or cancel the plan anytime of the year.

A healthy mouth can be key to your overall health, so it’s important to have dental benefits that count. With Anthem Extras you get:
Diagnostic and preventive care, including exams, cleanings and x-rays. Waiting period for services may be waived or reduced with prior coverage A third cleaning or gum maintenance if you have diabetes. Access to more than 32,000 dentists at over 66,000 locations.
The International Emergency Dental Program, so if you’re traveling outside the U.S. and need dental care, we’ll connect you with qualified dentists in almost any country in the world. You don’t need to get a referral to see a dentist. And you won’t have to worry about paperwork: Dentists in your plan will file claims for you.

  • Here is a list of dentists in the Sacramento area (Click Here).  If you would like a list of dentists close to you, just let me know and I can send you the contracted dentist list in your area.

Using a dentist in your plan Anthem Extras lets you choose any dentist, whether or not they’re in your plan. But you may have to pay
more if you use a dentist who’s not in your plan. That’s because dentists in your plan have agreed to accept certain rates for services — and they can’t charge you more. This rate is called the “maximum allowed amount.” Dentists who aren’t in your plan don’t have a contract with us and can charge whatever they want for services. If it’s more than the maximum allowed amount, they can bill you for the balance of their fee.
That’s called balance billing and it can cost you a lot more.

How does a PPO Dental Plan work?  Most PPO dental plans allow you to move freely to any dentist, in-network or out.  Although the plan will pay much more if you see a contracted in-network dentist.

First, the total bill will typically be reduced by 25% to 40% depending on the service provided, because of the network contracted dental rates.  Instead of a crown costing $1,200, the plan rate may be $850, then the insurance pays 50% of that which equals $420.

PPO Dental plans provide flexibility, allowing you to see different dentists within a PPO dental network.  Most PPO plans will say you can see any dentist, in or out of the network, although is is very important to stay within the network of dentists, because you will see the greatest savings when going to a contracted dentist.

Waiting Periods:  almost all PPO dental plans will have some sort of waiting period for “Basic” services along with “Major” services.  If you have dental insurance from another company or employer group plan, the new plan may honor the previous coverage and waive your new waiting periods.

If you are in a waiting period, you will still see impressive costs savings of 25% – 40% simply by seeing a network PPO dentist.  Because they are bound by the company and plan contracted and negotiated service fees.  Also, over 87,000 contracted dental offices nationwide.

Typical waiting periods are; Preventive care such as cleanings and X-rays (no waiting period).  Basic services include cavities and fillings and common tooth extractions (6 month wait). Major service are; Crowns, bridges, gum surgery, implants, root canal (12 month wait).

Please feel free to contact me anytime with questions.

John Conner

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Medicare Plan Options ... Medicare Supplement, Medicare Advantage, Medicare Part D Rx

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