Introduction To Dental Insurance
Please note the maximum payouts/year are generally $1,000 or $1,500 and sometimes 6 months to one year waiting periods to get major services, There are also rules so that insurance companies can stay financially solvent like the 80% Medical Loss Ratio, rule and underwriting to avoid adverse selection so IMHO he more important issue is:
- What plans do you have to take care of your families financial issues and putting food on the table should the breadwinner pass away, not be able to do all the duties that his work requires or fully able to take care of himself?
Get Quotes & Enroll
Try turning your phone sideways to see the graphs & pdf's?
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- Appoint us as your broker
- 17 Reasons to appoint us as your agent - broker
- VIDEO on ARPA Stimulus and more Covered CA Subsidies
- Set Consultation Meeting via Phone, Skype or Zoom
- Get Instant Health Quotes, Subsidy Calculation & Enroll
- Videos on how great agents are
- I'm in Sonia VIDEO
- Go into your Covered CA account or use our Instant No Obligation Quote Engine
- Dental Options – Add the plan you want to your cart
- Click on Shop for Dental
- Plans outside of Covered CA – Dental for Everyone
- Delta Dental Individual & Family™ Delta Dental PPO™ Family Dental Plan
- Delta Dental Individual & Family™ DeltaCare® USA Family Dental HMO
- If you have trouble locating the brochures, email us [email protected]
- One of our colleagues on how Dental for Everyone Works.
- Some of our webpages on dental
- VSP Vision
Be sure to put in our AGENT # 2094784
Delta Dental – Covered CA Plans
- Delta Dental PPO Premium Plan covers implants at 50%, after a 12-month waiting period.
- Delta Dental Individual & FamilyTM Delta Dental PPOTM Family Dental Plan 669 KB
- Delta Dental PPOTM Children’s Dental PPO for Small Businesses 790 KB
- Delta Dental PPOTM Family Dental PPO for Small Businesses 794 KB
- Delta Dental Individual & FamilyTM DeltaCare® USA Family Dental HMO 872 KB
- DeltaCare® USA Children’s Dental HMO for Small Businesses 837 KB
- DeltaCare® USA Family Dental HMO for Small Businesses 848 KB
- Dental care reduces likelihood of hospitalization for people with diabetes or coronary artery disease Medical Press 5.6.2022
- The 2022 State of America’s Oral Health and Wellness Report Commissioned by Delta Dental Plans Association
- What drives buyers of individual Delta Dental plans?
- Why Buy Dental Insurance? VIDEO
- What dental Insurance... should I buy???
VIDEO the dentist attempts to give you some guidance about things to consider before buying a dental insurance plan, finance plans available, negotiating with your dentist
- Sacramento Truck driver sudden dealth from tooth infection Sacramento Bee 1.31.2017
- Health Savings Accounts?
- Video - how bad sugary drinks are for you
Pediatric Dental and Vision are Mandatory essential benefits under Section “J” 42 USC 18022 SB 951, even if there are no children on the policy. If there are no children, you are not getting charged see FAQ below for more detail.
- Resources & Links
- Blue Shield Trio HMO EOC Evidence of Coverage 2019 Page 50 for Dental & 112 for Vision
- HBEX Pediatric Policy Brief 11 pages 7.17.2013 PDF
- Blue Shield Graphic on Pediatric Dental & Vision
- Covered CA – Ask us [email protected] or log into your account and click on Select Dental Plan in right hand side under Actions
- Delta Dental VIDEO Changes with Health Care Reform Pediatric Dental
Our other pages on Dental Coverage
We don't put a lot of effort into selling dental coverage. Generally it's a wash on paying premiums vs getting back claims payments. Unless it's employer group. Then the premiums are tax deductible under IRS Section 106.
Here's more information on how we feel about dental. Here's our page on implants, where we get lots of inquires, but few sales. Most people only seem to want dental coverage, after they've been told they need a lot of dental work. Not profitable for Insurance Companies. See our other pages for details & explanations. See our page on Medical Loss Ratio. Insurance Companies need to take in $1 to pay 80c in claims.
- Blue Cross Dental & Vision
- Blue Shield Dental & Vision
- Original Medicare Dental under Medicare is very limited
Individual & Family Plans
- Blue Cross Dental
- Blue Shield Dental & Vision
- Health Net Dental & Vision
- Dental & Vision for Adults and Mandatory Pediatic as an essential benefit
- Child Dental & Vision
- Covered CA & More
- FAQ’s – Explanations – Technical Info
Dental For Everyone,
has an excellent website with full brochures, Instant online quoting and enrollment
One of our colleagues on how Dental for Everyone Works..
Employer Group Plans
Coordination of benefits – two or more policies in force?
Is it worth it and safe to have dental coverage, during the pandemic as people are postponing routine cleaning, etc, during the pandemic?
Blue Cross has already announced lower rates and that they are paying extra to the dentists for COVID 19 extra costs to prevent transmission.
If no one goes to the dentist, under the Medical Loss Ratio rule, Insurance Companies will have to give rebates, so that they pay out 85 cents on every dollar they take in .
Anthem issues premium credits to employer groups
We continue to look for ways to provide support and financial relief to our employers and members during the COVID-19 emergency.
Shelter-in-place orders across the country have caused significant disruption to traditional patterns of care. As a response to these challenges, we are supporting our customers by issuing premium credits to our Fully Insured employer groups based on their April 2020 invoices.
The credits will appear on employers’ August 2020 invoices (issued in July 2020):
• 15% of the April premium for Anthem Small Group medical plans
• 50% of the April premium for Anthem Dental plans – Source – Broker Email 6.5.2020PPE reimbursement protects members and supports dentistsCOVID-19 requires that dentists take extra precautions to protect both themselves and their patients. These added steps can add to the cost of a dental visit.
To protect the health of our members while minimizing unexpected fees, we are paying dentists an extra reimbursement from June 15 through August 31, 2020.
Anthem will pay $10 per dental patient, per visit, on dental PPO network claims for personal protective equipment (PPE).
Supporting the dentists in our networks can help preserve employee access to providers in their plans. Broker email dates 6.22.2020
is it safe to go to the dentist?
COVID-19 spreads primarily through respiratory droplets that often make their way into your mouth, nose, or even eyes, you may be putting yourself in danger while sitting in the dentist chair (remember: dental hygienists and dentists are all up in your mouth during cleanings and procedures—and you wearing a mask is basically impossible).
questions to ask medical and dental staff when scheduling an appointment:
Do the staff and patients wear masks at all times?
Do the staff have enough masks and protective equipment?
Will there be a limit on how many people can be in a waiting room?
Are the staff being tested for COVID-19?
How often are staff cleaning the waiting rooms and offices?
If you don’t drive, can you take public transit while keeping your distance from other people and washing your hands before and afterward?Evidence of Coverage for Delta Dental PPOTimely Access to CarePPO and Premier Providers have agreed waiting times to Enrollees for appointments for care which will
never be greater than the following timeframes:
for emergency care, 24 hours a day, 7 day days a week;
for any urgent care, 72 hours for appointments consistent with the Enrollee’s individual needs;
for any non-urgent care, 36 business days; and
for any preventative services, 40 business days.
During non-business hours, the Enrollee will have access to his or her Provider’s answering machine,
answering service, cell phone or pager for guidance on what to do and whom to contact if he or she is
experiencing an Emergency Dental Condition.
If the Enrollee calls our Customer Service Center, a representative will answer their call within 10 minutes
during normal business hours.
Should the Enrollee need interpretation services when scheduling an appointment with any of our PPO or
Premier Providers, he or she may call our Customer Service Center at 800-471-0287 for assistance.
limited to enrollees who have been enrolled in the Contract for 6 consecutive months
Periodontics (other than maintenance)
Crowns and Casts