Enables members to receive healthcare services wherever they live or travel, nationally or internationally. Box 986030, Boston, MA 02298. Preventive care like exams and cleanings. With BlueCare Dental PPO, you'll get: One of the highest maximum annual benefit levels available - up to $1,500 per person per year Up to a 20% discount, up to a maximum savings of $1,000 for orthodontic services at participating dentists For more information on coverage and benefits, view the BlueCare Dental Outline of Coverage PDENT is your dental plan. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Use our Find a Provider tool to BlueCard Enables members to receive healthcare services wherever they live or travel, nationally or internationally. PDF BlueCare Dental PPO - BCBSIL Below are answers to some of the frequently asked questions. BHI brings together the healthcare experience of more than 54 million Blue Cross and Blue Shield members nationwide. H\j@{\lP|di An information system that incorporates membership data and provider reimbursement arrangements and analyzes transactions according to contract rules. Overview Adult Dental Pediatric Dental Overview About this plan Alberta. Blue Access for Members SM(BAM SM) The gateway to help manage your personal health information. 00421 An itemized statement of healthcare services and their costs provided by a hospital, physician's office or other provider facility. 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. Up to $800 of the $1,200 in-network total can be used toward out-of-network care. 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. H\n0E 0000002644 00000 n BCBSTX Dental Plans | Texas Health Agents Call Dentaquest at 1-800-516-0165, MCNA Dental at 1-800-494-6262 or UnitedHealthcare Dental at 1-800-822-5353. Summary of Benefits and Coverage | bcbsm.com We calculate our dental premiums based on your location (rating areas) and the plan option you select. BlueCard applies if the provider of service is outside the member's Blue Cross Blue Shield Plan's service area and does not contract with the member's Plan. 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 . Learn more about dental services for adult STAR members, 8 a.m. to 5 p.m. Central Time Monday through Friday. 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. Preventive care programs designed to determine if a health condition is present even if a member has not experienced symptoms of the problem. You may also ask us for a coverage determination by phone at 1-888-285-2249 (TTY:711), We are open 8 a.m. - 8 p.m., local time, 7 days a week. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. An employer that has offices or branches in more than one location, but offers uniform healthcare coverage of benefits to all of its employees. A group of healthcare providers that agrees to deliver coordinated care, meeting performance benchmarks for quality and affordability in order to manage the total cost of care for their member populations. 0000058858 00000 n BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Healthcare services provided to a health maintenance organization (HMO) member in exchange for a fixed, monthly premium paid in advance of the delivery of medical care. BCBS FEP Dental has nearly half a million provider access points nationwide to receive in-network services, a customer service team dedicated to exceeding your expectations, online tools to make your life easier, and a variety of options and benefits to meet your needs. takes the health and well-being of our members, providers, our associates and our business partners seriously. You pay 50% after deductible before meeting your out-of-pocket max, and $0 after meeting your out-of-pocket max. Get access to your member portal. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. For all of your dental questions and/or claim forms, please contact your local Blue Cross Blue Shield company. Get access to your provider portal. Limitations and Exclusions Exclusions 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. Auxiliary or supplemental services, such as diagnostic services, home health services, physical therapy and occupational therapy, used to support diagnosis and treatment of a patient's condition. Choose from a variety of affordable group health plans to fit the needs of your employees and your business. Oral health touches every aspect of our lives but is often taken for granted. If you are a BCBSIL member and have questions about your health care plan benefits, check with your group benefits administrator or contact Customer Service at the number listed on your BCBSIL member ID card. PDENT is your dental plan. Dependent coverage Unmarried dependent children are covered under age 26 or under age 30 if a military veteran. A set of specialized healthcare services that provide support to terminally ill patients and their families. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. The site may also contain non-Medicare related information. After a 12-month waiting period, cover is extended to major procedures including dentures, implants, crowns and orthodontics - all subject to an annual maximum of $1,500. (Coverage is not available for non-network dentists in Massachusetts except for covered emergency services.) A computerized record of a patient's clinical, demographic and administrative data. In Texas, Medicaid is the program that will offer the most comprehensive dental coverage, especially for children (anyone under 21). A specified dollar amount that a member must pay out-of-pocket for a specified service at the time the service is rendered. 1996-2022 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Space maintainers are covered once per quadrant every two years for members to the end of the month of their 15th birthday. Blue Distinction Centers for Specialty Care, Need to Make a Payment? A large group may be defined as more than 250, 500, 1,000, or some other number of members, depending on the managed care organization. Root canals The website lets members log daily activities and track progress over time. 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). 0000017596 00000 n 0000005103 00000 n 44 79 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. Blue Cross MedicareRx SM Attn: Medicare D Clinical Review . xref For Employers: Plans for small groups | bcbsm.com Register Now, Not registered? 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. 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. 0000006892 00000 n 0000006502 00000 n During this unprecedented time, we're taking action to support our members. A doctor, hospital or other healthcare entity enrolled in a network of designated PPO providers. Non-contracting dentists will charge employees their regular fee and may bill them for the balance not covered by the dental benefit plan. 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. Anthem's medical plans offer healthcare coverage you and your family can rely on. Your deductible is the amount you pay for dental services each year before your insurance begins to pay. 0000009480 00000 n 0000036033 00000 n Log in and look. You can buy this plan if you live in any Michigan county. The provider of service is the one who files a claim for a service supplied to the member. Download or print your benefit information. Call us at (312) 726-6565 Benefits & Rates A process through which an organization validates credentialing information from the organization that originally conferred or issued the credentialing element to the practitioner. BlueCare Dental Connection integrates dental care management and health care management with a focus on preventive care and individual involvement. Limited to three times a year in combination with routine cleaning. Also known as a group practice model HMO. For more detailed information on the plan designs available, covered benefits, services and supplies that are limited or excluded, general administration of the plan, or any other questions you may have regarding our products and services, please contact your account representative for the phone number of the regional sales office near you. Fillings A health maintenance organization (HMO) that contracts with a group of physicians with multiple specialties who are employees of the group practice. Blue Cross and Blue Shield of Texas (BCBSTX) covers emergency dental services your child gets in a hospital or ambulatory surgical center. There are three ways to enroll in BlueCare Dental PPO: Select 'YES' next to the Dental option when you apply online for any qualifying Blue Cross and Blue Shield of Texas health plan. A coordinated system of preventive, diagnostic and therapeutic measures intended to provide cost-effective, quality healthcare for a patient population who have or are at risk for a specific chronic illness or medical condition. Understanding yourBlue Cross Blue ShieldFEP Dental coverage is the key to making the most of your Bridges and dentures Blue Cross Blue Shield of Minnesota For Providers: Drug lists | BCBSM 0000002318 00000 n To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. Limited to once every 24 months for primary teeth, and once every 48 months for permanent teeth. We provide health insurance in Michigan. Need help understanding and choosing a benefit plan? The integration of financing and delivery of healthcare within a system that seeks to manage the accessibility, cost and quality of that care. An extension of the Blue Cross Blue Shield WalkingWorks program, this event helps people incorporate physical activity into their workday and encourages them to increase their daily physical activity by walking at lunch. You can watchthis videoto meet your health plan advisors. Questions? This is the limit on what your plan pays for dental care benefits for members who are 19 or older when their plan starts. The direct care provider is in the same physical location as the member and offers care to patients from within the local Plan's service area. 0000005163 00000 n Personal Health and Dental Plan - Pacific Blue Cross 0000139544 00000 n An organization that provides dental services through a network of providers to its members in exchange for some form of prepayment. Patients and members can also call Yavapai Regional Medical Center at 702-616-5789 for assistance or questions. Documentation errors in which a treatment is miscoded or the codes used to describe procedures do not match those used to identify the diagnosis. Fillings 0000005826 00000 n 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. Teeth cleaning (prophylaxis) TTY users dial 711. Additionally, members may have to submit claims for reimbursement. This new site may be offered by a vendor or an independent third party. Please refer to your Dental Benefit Booklet for additional benefit information. What are the side effects of Thiazolidnedions. Table of Contents. Blue Cross Blue Shield of Massachusetts, P.O. These cards assist PBMs in processing and tracking pharmaceutical claims. Basic services like fillings and root canals. Need help understanding and choosing a benefit plan? Bridges and dentures 0000014575 00000 n A toll-free number, 1-800-676-BLUE, for healthcare providers to verify Blue Cross Blue Shield membership and coverage information for patients. This new site may be offered by a vendor or an independent third party. Space maintainers Dental Provider Network - Blue Cross Blue Shield of Illinois WalkingWorks is a physical fitness and wellness program developed by Blue Cross Blue Shield, in cooperation with the Presidents Council of Physical Fitness and Sports, to help BCBS members reach fitness goals while improving your overall health. Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross . +3. Get access to your employer portal.Register Now, Not registered? 0000088308 00000 n endstream endobj 66 0 obj <> endobj 67 0 obj <>stream Please note, this is a summary of features of Blue Cross Blue Shield FEP . Temporomandibular Joint Disorder (also known as TMJ, TMD, or TMJD) is also a disease that medical insurance carriers still question.