Dental plans

Dental PPO

The dental PPO network includes over 47,000 provider access points in California. Our national PPO network includes 390,000+ access points*. Our dental PPO plans provide employees with a wide range of benefits, including 100% coverage for diagnostic and preventive services from participating network dentists; in-network utilization is more than 70%.
 

Dental In-Network Only (DINO)

DINO plans have in-network benefits but no out-of-network benefits. The DINO plans utilize the full DPPO network.

A new Triple Choice Dental Option has been added with the following plan options: 1 DPPO plan + 1 DHMO plan + 1 DINO plan. Employers may choose this option and a combination of plans that best meet their employees’ needs.
 

Dental HMO

The dental HMO network includes 22,000+ provider access points. Our six dental HMO plans complement our dental PPO plan portfolio. Employers can offer dental benefits for basic and major services with no waiting periods, deductibles, or calendar-year maximums. The dental HMO plan portfolio helps simplify dental coverage for your clients by offering lean, middle or rich benefit designs.
 

Two-year rate guarantee

All new and renewing groups adding dental receive a two-year rate guarantee on their dental coverage, giving them added financial predictability for budgeting and planning.
 

With Benefit Solutions, the more you add, the more you save

Our improved bundling program now applies to groups of 101 up to 1,000. Your clients can save up to 3% on their medical rate by bundling dental, vision‡, and life insurance‡ with their medical benefits.

• Choose dental and save 2%
• Add vision, and save another 0.5%
• Add a minimum of $25,000 in life insurance and save and additional 0.5%

Learn more about Benefit Solutions

Diagnostic and Preventive Care waiver

Members can get more from select DPPO dental plans with our Diagnostic and Preventive Care waiver program. Diagnostic and preventive claims that would have gone against the calendar-year maximum are waived so employees get more from their plan. This waiver program encourages employees to seek preventive care and address small problems before they become big ones. 

Learn more about the Diagnostic and Preventive Care waiver program

Dental Smile Rollover Rewards program

Dental Smile Rollover Rewards is another benefit with select DPPO plans. Members are rewarded for visiting the dentist at least once a year. As long as the annual paid dental claims are below the claim threshold, the member receives a reward. If members see a dentist in the PPO network versus a non-network dentist, the members receive an additional boost to the amount of their reward. The reward amount is based on the dental plan’s calendar-year maximum and the program's annual claims threshold for the plan. Any rewards earned will roll over in the form of calendar-year maximum funds and raise the member’s calendar-year maximum for the benefit year. 

Learn more about the Dental Smile Rollover Rewards program

Orthodontic coverage option

Our coinsurance amount is 50% with an annual maximum of up to $1,000 or up to a lifetime maximum of $2,000. Orthodontic plans also offer an allowance for Invisalign and clear braces. The member simply pays the difference between the cost of the clear braces and what is paid for traditional orthodontic treatment (braces). 

Learn more about our Orthodontic plans
 

Implants as a standard benefit

Implants are covered as a major service on all dental HMO, INO, and PPO plans. Member responsibility varies based on the plan design. Details can be found in the Evidence of Coverage and the copy schedule for each plan. 

Learn more about the implants standard benefit
 

Caries risk management

Additional benefits for children to help prevent or treat tooth decay.

• Dental Pediatric One Pager on the importance of early childhood dental care
   

Oral cancer screening benefit

All dental HMO, INO, and PPO plans include an oral cancer screening benefit covered at 100%. Oral cancer can hide below the surface, and early detection greatly improves the success of treatment.
 

Teledentistry services

Blue Shield of California eligible plans have virtual visits with licensed dentists.

Dental advice and guidance will be provided for Diagnostic and Preventative benefits.

A virtual visit with a dentist is intended to promote oral hygiene as well as address any dental health concerns, both urgent and non-urgent. The dentist will usually ask a series of diagnostic questions and sometimes request photos or videos to view the mouth. Based on the situation, the dentist may make a diagnosis, suggest treatment options, or recommend a follow-up visit.

Members may see their own dental provider if they have Teledentistry capabilities or they may use any dentist with Teledentistry capabilities. As with any dental service, an in-network provider is recommended.
 

Third cleaning for pregnant women

Periodontal treatment during pregnancy may reduce premature births. That’s why we provide one additional cleaning for pregnant women in all of our dental PPO, INO, and HMO plans. A third periodontal maintenance visit is also covered, if needed, to treat periodontal disease.
 

Blue Shield member portal and app

Members can get easy access to benefit and coverage information, claims payment and status updates, and digital ID cards through blueshieldca.com when they register their account. For on-the-go access, members can download the Blue Shield app on their mobile devices.
 

See the value

Help your clients see the value that dental coverage can bring them. Share the infographic, Why You Need Group Dental Coverage.