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Below explanation is for California plan only

Anthem Blue Cross logo  Anthem Blue Cross Dental SelectHMO Insurance 
(877) 566-5454 Toll Free

Anthem Blue Cross DENTAL SelectHMO PLAN MONTHLY RATES
Effective 1/01/17
Enrollees all ages
Single $17.40
Two Party
Member & Spouse or
Member & Child
$35.50
Family (three or more)
Member, Spouse & Child or
Member & Children
$53.30

ANTHEM BLUE CROSS DENTAL SelectHMO
DENTAL SelectHMO
In-network only
Annual Deductible None
Annual Maximum None
Annual out-of-pocket limit None
Diagnostic & preventive services No waiting period
Cleanings, exams & X-rays Copay
Basic services 6-month waiting period
Fillings Copay
Complex & major services No waiting period
Oral Surgery Copay
Endodontics Copay
Periodontics Copay
Prosthodontics Copay
Orthodontics Child-$2,870 Copayment
Adult-$3,045 Copayment
Retention-$210 Copayment
Blue View Vision Available
Brochures SelectHMO Brochure
Evidence of Coverage SelectHMO Evidence of Coverage
Applications SelectHMO Application

* Chart reflects copayments when services are rendered by a participating dental office.
     Amounts may differ if services are obtained through a participating specialty office.

PRINT & MAIL Application - Anthem Blue Cross Dental SelectHMO Application

Anthem Blue Cross Dentist Database


Or you can fill in this form to have your Anthem Blue Cross SelectHMO Dental Insurance brochure with pricing & application mailed to you. Further information on our plans is shown below. Or just call us Toll-free at 877-Look4Life (877-566-5454).
Anthem Blue Cross HMO Dental Insurance Coverage Requested
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People Covered

Customer Information
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Dental HMO (Dental Health Maintenance Organization) plans also referred to as pre-paid plans, require you to choose one dentist or dental facility to coordinate all of your oral health needs. If you need to see a specialist, your primary care dentist will refer you; specialty care may require preauthorization. A typical DHMO-type plan doesn't have any deductibles or maximums. Instead, when you receive a dental service, you pay a fixed dollar amount for the treatment (a "copayment"). Often, diagnostic and preventive services have no copayment, so you pay nothing for these services. However, generally if you visit a dentist outside of the network, you may be responsible for the entire bill. Typically, the least expensive of dental plans.

Dental PPO (Dental Preferred Provider Organization) plans offer a network feature and usually offer a balance between lower costs and dentist choice. PPO dentists participate in the network thereby agreeing to accept contracted fees as payment in full rather than their usual fee for patients with the PPO. When you visit a PPO dentist, you typically pay a certain percentage of the reduced rate (called coinsurance) and the plan pays the rest. The percentage usually varies by the type of coverage such as diagnostic and preventive, major services. While you typically have the lowest out-of-pocket costs if you visit a PPO dentist, the plan allow you to visit the dentist of your choice, even if they are not in the network. Typically, the most expensive of dental plans.

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Barricks Insurance Services
276 N El Camino Real #6, Oceanside, CA 92058
Phone:  (760) 433-0300   |   Fax:   (760) 433-0304
Toll-Free 1-877-Look4Life  (1-877-566-5454)

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