Anthem Blue Cross of California
Anthem Blue Cross is expanding some dental services for individuals who suffer from certain medical conditions such as heart disease, organ transplants, and people undergoing cancer treatment. The expanded cleanings and periodontal maintenance applies to members of Anthem Blue Cross dental plans effective January 1, 2016.
New benefits for dental members to keep their healthy smiles
What we cover
We already cover additional dental services for members enrolled in both an Anthem medical plan and an Anthem dental plan,2 who are pregnant or living with diabetes and actively managed in one of our health care management programs.
What new conditions are eligible?
As of January 1, 2016, we extended this benefit to other conditions, including:
- Heart conditions – including heart disease, an enlarged heart, and mitral or aortic valve prolapse
- Organ or bone marrow transplant
- Cancer (any type) treated with chemotherapy
- Head or neck cancer treated with chemotherapy and/or radiation therapy
How to receive an additional cleaning
To get their extra dental cleaning or periodontal maintenance procedure, eligible members simply visit their dentist and submit their claim. It is part of their dental coverage as of January 1, 2016, if they are being actively managed in one of our health care management programs.
Members who are actively managed in one of the designated care management programs listed above will receive this sample letter to let them know about the benefit. The letter will be customized to the member’s current care management program.
We’re here to help
Our health care management programs are an added resource to some of our health care plans. If members would like to sign up or learn more about one of the programs, direct them to call the Member Services number on their health (not dental) plan ID card. For questions about the additional dental cleaning or periodontal maintenance procedure, contact your sales representative.
1 Academy of General Dentistry Know Your Teeth website: Warning Signs in the Mouth Can Save Lives (Rev. January 2012): knowyourteeth.com.
2 Extra cleaning benefits apply to members in Dental Prime, Dental Complete and Dental Blue plans. Extra cleaning benefits do not apply to dental pediatric and family ACA plans (sold on and off exchange).
Anthem Blue Cross letter sent to members
Thank you for choosing <BRAND> Dental Prime/Complete® for your dental coverage. We are excited to offer our new program, <BRAND> Whole Health ConnectionSM, which links our health and dental benefits to support your overall health needs.
How the program works
As part of our new program, you can get extra dental benefits at no extra cost to you! You can now get:
Coverage for one extra dental cleaning to help keep your teeth healthy or
Coverage for one extra periodontal maintenance procedure to help keep your gums healthy
All you have to do to get your extra dental cleaning or periodontal maintenance procedure is visit your dentist and have the office file a claim for you like they normally would.
When do I have to get my extra dental benefit?
Since you are a part of an <BRAND> Care Management program, effective [insert diagnosis effective date], you are eligible for an extra dental cleaning or periodontal maintenance procedure per benefit period for as long as you are enrolled in your current dental plan and are an active participant in the <BRAND> Whole Health ConnectionSM program.
Questions?
Please call the Customer Service number on your dental ID card. We are happy to help you and your teeth stay healthy!