Plan details for dependents under age 19 are not shown above. Prescription drug coverage and claims are managed by your pharmacy benefits manager an independent company that specializes in these. Dpkh23natstxo this information only provides a summary of the benefits for this dental plan. Use your bluecare sm or tenncare select member id card for dental care. There are three ways to enroll in bluecare dental ppo. Annual maximum does not apply to members up to age 21. Find a doctor or hospital blue cross blue shield of oklahoma. The bluecare dental contract is of a limited nature and, as such, is not required to meet the minimum standards for accident and sickness insurance prescribed by law. Information about the cost of this plan called the premium will be. Managed care fmc ist hin prasent, zusammen mit bluecare. As the health impact of covid19 grows, we appreciate the care you and your staff provide for patients covered by our plans more than ever. With bluecare dental ppo, members have the option to receive care from dentists who are not in the network. Call 18005079820 or visit us at if you arent clear about any of the underlined terms used in this form, see the glossary.
The deductibles, coinsurance and benefit period maximum shown below are subject to change as permitted by applicable law. Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, hospital services, accepted doctors and more. Dental provider network blue cross blue shield of illinois. In the event there is a conflict between this summary and your florida blue coverage documents the terms conditions of the coverage documents will control. Nonparticipating providers outofnetwork nonparticipating providers have not contracted with bcbsmt to provide services at negotiated rates, and your. If you arent clear about any of the underlined terms used in this form, see the. The sbc shows you how you and the plan would share the cost for covered health care services. For full information refer to your certificate of benefits booklet. Whats the difference between an epo and a ppo dental plan. Bluecare everyday health 1477c schedule of benefits this schedule of benefits is part of your contract, where more detailed information about your benefits can be found. Bluecare direct hmo kit3oocppo 1209 anthem blue cross and blue shield is the trade name for anthem health plans, inc. Bluecare dental sm 1b blue cross blue shield association. Dental sg 2015 dpfh23natsmto fld bluecare dentalsm 1a participating providers innetwork bcbsmt has a participating dental network. Bluecare dental sm for student health if you are enrolled in the academicblue sm student health insurance plan available at the university of illinois springfield, you have the option to purchase dental coverage from blue cross and blue shield of illinois.
Bluecare dental classicsm plans blue cross and blue shield of. Provider administration manual prior authorization information. Complete your health care coverage with affordable dental insurance plans from blue cross. Employees must select a contracting dentist to provide and coordinate dental care for them and their dependents. To help you make an informed decision about your dental coverage, a small group 1 to 100 employees summary of dental benefits document is available for each of our fullyinsured plans. Bluecare dental classicsm plans blue cross and blue. Find 2 listings related to bluecare tenncare dentists in knoxville on. In the event there is a conflict between this summary and your florida blue coverage documents the terms and conditions of the coverage documents will control. Bluecare dental hmo sm advantage the bluecare dental hmo plan encourages your employees to maintain good dental health by offering full coverage for preventive and diagnostic care. Annual maximum does not apply to members under age 21. The ppo dental plan provides a higher level of benefits when. Bluecare dental 4 kids sm 1a for members under age 19 marketing id. Bluecare dental connection sm blue cross blue shield.
Health care providers bluecare plus dsnp bcbs of tennessee. Bluecare dental hmo gives you the convenience of receiving affordable dental care from one of the largest dental hmo networks in illinois. The following is a listing of common services available through your bluecare dental ppo network. Bluecare dental hmo offers a dental network that is one of the largest in illinois.
Bluecare dental ppo small group summary of benefits blue. The members share of the costs is determined when care is received from a contracting dentist. Region i consists of anyone living in the following zip codes. Bluecare dental 1a blue cross blue shield association. Nonparticipating providers outofnetwork nonparticipating providers have not contracted with bcbsmt to provide services at. A division of health care service corporation, a mutual legal reserve company, an independent licensee of the blue cross and blue shield association 732646. Prior authorization is required for certain procedures, services and medications, as well as for all inpatient admissions. Michigan health insurance customer service dental plans. Bcbsnc offers a range of health plans for groups and individuals. Health care service corporation bcbstxoffers bluecare dental and bluecare dental 4 kidssm. If choosing bluecare dental 1b, refer to bluecare dental 4 kids 1b for plan details for dependents under 21.
Information on a wide range of dental topics, like pediatric care, prevention, treatments and dental diseases. Children and young adults under 21 are also covered for dental care. Bluecare dental classic for individuals insure with integrity. Search for a doctor by name, location or specialty to find a doctor in your area to meet your health care needs. Bluecare classicsg choice 1 summary of benefits and. Dentaquest manages dental claims and services for tenncare members. The bluecare dental ppo product is a product available for purchase on a selffunded basis only.
The bluecare dental ppo product is a product available for purchase on a self funded basis only. The deductibles, coinsurance, benefit period maximum and outofpocket maximums shown below are subject to change as permitted by. It is, therefore, important that you read your policy carefully. Get health insurance plan info on bluecare bronze 1483 from florida blue hmo a bluecross blueshield fl company. You can choose your dentist from our statewide provider network, at a low monthly rate. Bluecare dental 1b and bluecare dental 4 kids 1b feature. Select yes next to the dental option when you apply online for any qualifying blue cross and blue shield of texas health plan.
Your blue medicare supplement insurance plan helps you pay for some healthcare costs that original medicare doesnt, but. Bluecare dental 4 kidssm 1b blue cross and blue shield of texas herein called bcbstx, we, us, our required outline of coverage i. For 70 years weve been helping our friends and neighbors use their health plans to get well and stay healthy. Jul 01, 2020 bluecross adopts and disseminates specific nationally recognized clinical practice guidelines for use by our network providers. For more information on available dental plans, please choose. Like a medical hmo, you must select a participating primary care dentist to provide and coordinate dental care and treatment for you and your eligible dependents.
Independent licensee of the blue cross and blue shield association. The summary of benefits and coverage sbc document will help you choose a health plan. Bluecare dental 1b blue cross blue shield association. International students mandatory all international students holding. Bluecare dentalsm 2a blue cross and blue shield of texas herein called bcbstx, we, us, our required outline of coverage i. With the bcbstx dental plans, youll get dental coverage on day one with no deductible deductible. Summary of dental benefits blue cross blue shield association. Delivering innovative heath insurance coverage to north carolinians for over 65 years. Our dental plans provide you with savings on preventive services like checkups, cleanings and basic xrays, as well as on procedures like fillings, bridges and crowns. The ppo dental plan provides a higher level of benefits when members receive treatment from bluecare dental participating providers. Bluecross adopts and disseminates specific nationally recognized clinical practice guidelines for use by our network providers. This is not the insurance policy and only the actual policy provisions will control. This information only provides a summary of the benefits for this dental plan. For existing members, discover all the advantages the bluecare dental connection can offer you.
If choosing family coverage, for bluecare dental 1a please refer to bluecare dental 4 kids 1a for plan details for dependents under 21. This bluecare dental coverage is designed to provide you with economic incentives for. Bluecare dental sm and bluecare dental 4 kids sm for more information on available dental plans, please choose one of the options below. Florida blue provides plan brochures and summaries of benefits and coverage sbc for each of our plans. If choosing bluecare dental 1b for family coverage, please refer to the policys certificate of benefits booklet. The members share of the cost is determined by whether care is received from a contracting or noncontracting provider. Important notice due to covid19 emergency temporary guidance regarding provider administration manual 41620 to our valued providers. Blue cross and blue shield of illinois has separate dental plans that help you save on preventive services like checkups, cleanings and basic xrays. Our dental insurance plans provide you with savings on preventive services like checkups.
An outline of coverage provides a very brief description of some important features o f the bluecare dental ppo rider. If you are a member with either employer offered dental benefits or employer offered medical and dental benefits, you can go to bluecare dental connection by logging in to blue access for members. Bluecare dental pposm blue cross blue shield of texas. Our bluecare dental classic plans also help you save on procedures like fillings, bridges and crowns. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at. To help you make an informed decision about your dental coverage, a nrmm 1 to 100 employees summary of dental benefits document is available for each of our fullyinsured plans. This policy is issued in the state of texas and is governed in accordance with the laws of this state. Blue care dental connection blue cross and blue shield of texas. Dpfl03natstxp this information only provides a summary of the benefits for this dental plan.
Bluecare dental ppo blue cross blue shield association. This bluecare dental coverage is designed to provide you with economic incentives for using designated dental care providers. Utilize tools like ask a dentist, dental wellness center. Bluecare dental pposm blue cross blue shield association. Bluecare dentalsm 2a blue cross blue shield association. The guidelines address acute and chronic medical services, and behavioral health services to assist practitioners in making appropriate health care decisions for specific clinical circumstances. These documents highlight key features of your plan or coverage, such as the covered benefits, costsharing provisions, and coverage limitations and exceptions. The bluecare dental hmo network includes specialists such as oral surgeons, orthodontists, pediatric dentists, endodontists specialists in diseases of the nerve within the tooth and periodontists specialists in diseases of the gums and tissues. Bluecare dental hmo sm advantage blue cross blue shield. Please refer to your dental benefit booklet for additional benefit information. You have the right to return the contract for any reason within 10 days of its delivery to you and have any paid dues refunded to you. Dnmhr04 this information only provides a summary of the benefits for this dental plan.
Find a doctor or hospital in oklahoma quickly and easily using the blue cross blue shield of oklahoma provider finder. With the spread of the coronavirus in tennessee, were adapting for our members health. This outline of coverage provides a very brief description of some important features of your policy. Bcbsil offers two plans for both adults and children, designed to fit your needs and your budget. The policy itself sets forth in detail the rights and obligations of both you and blue cross and blue shield of illinois the plan. This outline of coverage is not the insurance rider and only the actual rider provisions will control.
317 657 803 174 1379 643 51 407 290 1263 373 259 200 810 863 1491 277 1353 721 1013 802 559 1484 1232 1431 205 531 1277 1154 1141 1163 592 947 1329 108 1354 91 477 844 596 870 568