Anthem Dental Insurance

One of the nations top insurers

Anthem, also known as Anthem Blue Cross or Anthem Blue Cross Blue Shield, is one of the nation's best-known insurers, offering a variety of health coverage through several different brands. Taken together, Anthem brands represent one of the largest health benefits providers in the country. While widely known for their health insurance products, Anthem also has a robust selection of specialty insurance plans which includes dental coverage. Anthem dental insurance products cover Americans across the country and the company boasted total dental membership of over six million people for the year 2020. Anthem's dental products can be purchased individually by consumers or in group policies for businesses.

Anthem's presence in the dental market extends beyond consumers. Their Dental Provider Savings Program provides discounts up to 40% to dentists on office devices such as scanners and personal protective equipment, lab services (implants, clear aligners, dentures), and dental telemedicine technology. Anthem has also upgraded their online portal for dentists to submit their patients' claims as well as verify patient insurance eligibility for specific services before they are performed.

Anthem was named by Fortune Magazine as the #1 Most Admired Company within the Health Care Provider segment in 2020. In the same year the Anthem Foundation announced that it had committed $50 million to COVID-19 response and recovery efforts. These efforts include provisions for the safety of health care providers, mental & behavioral health support resources, and resources to combat food insecurity.

Anthem Essential Choice Dental Plans

A popular line of dental products from Anthem is the Essential Choice. The plans in this line include the Essential Choice Incentive, Essential Choice Bronze, Essential Choice Silver, Essential Choice Gold, and Essential Choice Platinum. All five of these plans are PPOs. PPO stands for “preferred provider organization.” A PPO has the lowest out-of-pocket costs for covered services among in-network dentists but still allows an enrollee to seek treatment out-of-network (albeit at higher costs).

Bronze

The entry-level of these options is the Bronze. It has the lowest premium among Essential Choice plans and has no waiting periods before preventive care such as annual teeth cleaning and oral exams can be received by an enrollee. Unlike other Essential Choice plans, the Bronze does not have any coverage for major dental work such as root canals or crowns. In contrast, other Essential Choice plans provide major dental coverage (usually with a waiting period). The deductible on the bronze plan varies by the number of enrollees. For a single person, it has a $50 deductible. Each additional enrollee within a family plan is another $50 deductible but the family deductible is capped at a maximum of $150 a year. This deductible is waived for diagnostic and preventive services if they are received in-network.

Silver

The Silver plan is the next entry in the Essential Choice insurance line. While many of its out-of-pocket costs are similar to the Bronze plan, it includes coverage for major dental services like crowns in contrast to the Bronze plan. This coverage for major dental work becomes active six months after enrollment. This delay is known as a “waiting period.”

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Gold

The Gold plan has a 50 percent higher plan maximum than either the Bronze or Silver plans. The plan will pay covered dental expenses costing up to $1,500 in a single year. The plan also has lower out-of-pocket costs for some services as compared to either than Bronze or Silver plans.

Platinum

The Platinum plan, while having a higher monthly premium than the Bronze, Silver, and Gold plans, has attractive out-of-pocket costs for services as well as a $2,000 annual plan maximum.

The Platinum plan also includes orthodontic coverage for children through age 18. This coverage has a maximum lifetime benefit of a $1,000 for qualified orthodontic care and a $150 lifetime deductible for these services.

Incentive

The Essential Choice Incentive PPO has the highest plan maximum within the product line. The plan will spend up to $2,500 annually on covered dental services. In comparison, the Bronze and Silver plans have a $1,000 plan maximum. The plan also includes rewards for enrollees who receive preventive care according to plan guidelines. Practically, this means that an enrollees out-of-pocket costs for fillings, crowns, and other selected services lower in the second and third year of coverage so long as the enrollee has at least one preventive care dental visit annually.

As was the case for the Platinum plan, the Incentive plan has orthodontic coverage for children under age 19. After satisfying a $150 orthodontic deductible, this coverage has a maximum lifetime benefit of a $1,000 for qualified orthodontic care.

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Cosmetic Dentistry Coverage

Are you interested in getting cosmetic dentistry but you were hoping to have some of the cost paid by insurance? While many dental plans do not cover cosmetic dentistry, the number of dental plans offering this benefit has been increasing. 

On DentalInsurance.com, the Plan Details page for each dental insurance option will summarize what the plan covers as well as differences in in-network/out-of-network costs for the patient. On the Plan Details page you can confirm if the below cosmetic procedures are covered, what the out-of-pocket obligations are for a patient, and if there are any waiting periods associated with the service:

• Teeth whitening
• Veneers
• White fillings
• Dental implants

The Plan Details page will also let you know if one of these benefits has a waiting period that requires a minimum enrollment period before insurance coverage becomes available for a cosmetic procedure.

Cosmetic dental care isn't standard for most dental plans but services like white fillings are being covered more widely in the dental plan market. Teeth whitening performed at a dentist's office is also gaining traction among a minority of plans. Veneers are less likely to be covered and dental implants are covered within full coverage dental plans, but may have a waiting period before the insurance company makes the benefit available to an enrollee.

For a more detailed treatment of this subject, see our feature explaining cosmetic dental insurance.

Frequently Asked Questions About Dental Coverage

What Are Some of the Additional Plan Options apart from PPO Dental Insurance?

PPO dental insurance is just one category of dental coverage. It is popular because of its wide acceptance and flexibility to use out-of-network dentists. Another form of dental insurance that operates similarly is indemnity dental insurance. This type of coverage is sometimes referred to as fee-for-service dental care. Another alternative, with more restrictive network conditions are HMO dental plans and dental savings plans. These options must be used in conjunction with in-network dentists. Finally, there is bundled dental insurance where dental benefits are combined with vision or hearing benefits within a single plan.

Are Individual and Family Dental Plans Offered in All States?

Yes. There are dental insurance options for single enrollee coverage and multiple enrollee coverage (i.e. family coverage) available in every state and in Washington D.C.

What Does Dental Insurance Typically Cover?

Benefits in dental plans are not standardized but most plans cover preventive and basic care. Examples of preventive care are annual oral exams and teeth cleaning. Basic care pertains to simple procedures such as a filling or tooth extraction. Major care is associated with expensive dental care such as root canals, crowns, dental implants, and dentures.

There are plans that cover preventive, basic, and major care. These plans are sometimes called comprehensive dental coverage. However, some comprehensive plans have delays before certain treatments are covered. These delays are known as waiting periods.

What Are the Limits on Annual Benefits?

PPO and indemnity dental plans have a maximum amount that the insurer will pay toward covered care every plan year. This annual limit is called a dental plan’s “maximum benefit.”

Is a Dental Plan Deductible the Same for a Family as It Is for an Individual Enrollee?

It depends on the plan. Some plans charge a separate deductible per enrollee (e.g. $50 a year). Other plans may have a fixed family deductible that is higher than what is charge to a single enrollee. Other plans charge no deductibles, whether an individual enrolls, or a family enrolls.

What Are Some Additional Insurance Options Apart from Dental Insurance from this Company?

Anthem, as a leading insurance company in America, offers a variety of plans aside from dental coverage. These include traditional medical/health insurance, stand-alone vision insurance, supplemental insurance, limited duration short-term insurance, travel medical insurance, and Medicare Advantage and Medicare Supplement/Medigap insurance plans.

In Which States Do You Offer Anthem Dental Insurance Plans?

Our website has both Anthem BlueCross dental plans and Anthem BlueCross BlueShield dental plans. Anthem BlueCross dental insurance plans are available for residents of New York and California. Our Anthem BlueCross BlueShield, in comparison, are available in 13 states. These states are Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, New York, Ohio, Virginia, and Wisconsin.

How Does Dental Insurance Work and Why Is It Worth Buying?

The first step in dental coverage begins with enrollment. A consumer selects a dental plan and completes this plan's online application form. After the application form is submitted, the applicant will be notified of when the insurance policy will become effective. This effective date is the first day when the enrollee may use the benefits of the plan such as its negotiated rates and cost-sharing for dental procedures. Some plans may have a waiting period restriction on more expensive dental care. A waiting period is a requirement for the enrollee to be covered by the plan for a minimum period of time (e.g. six months) before the plan will cover a more expensive procedure.

The enrollee will pay a monthly fee for insurance, which is known as a premium. The plan may also have a deductible amount (e.g. $50) that the enrollee will pay for covered care before the insurance plan starts contributing to costs. Finally, there are out-of-pocket costs for covered care. An example of out-of-pocket costs is a copayment, which is a portion of dental care cost paid out-of-pocket by the enrollee alongside what the insurance plan pays the dentist.

After enrollment, a customer enjoys covered dental care so long as he or she keeps paying the monthly premium. Many insurers offer online tools to customers to make using their dental coverage easier. Some offer teledentistry - access to dentists by phone after normal business hours and when you are traveling away from your regular dentist. Others provide estimators for out-of-pocket costs for covered services. Another online tool sometimes offered is the option of emailing a question to a dental hygienist. Still others offer internet-based ways to question a bill or file a dental claim.

The value in buying dental insurance comes down to a plan’s ability to save you money through negotiated rates on procedures, the plan’s contribution to your annual dental care costs, and the plan’s coverage for expensive procedures that may be unexpectedly needed.

What Are the Benefits of a PPO Dental Plan for a Family?

First and foremost, dental coverage encourages regular trips to the dentist that will catch oral health issues early and promote healthy teeth and gums. A PPO plan, in particular, provides a family with the option to use an out-of-network dentist if they believe they will receive better care from this provider. In a family plan, they may also have a cap of deductible costs, which can save a large family money each year.