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Below explanation is for California plan only

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

    Northern California   Southern California -
  (Los Angeles, Orange,
  Riverside, San Bernardino,
   San Diego, Ventura)
  Subscriber Only $30 $35
  Subscriber & Spouse $60 $70

Preventive & Diagnostic Care Procedures
Participating Dentist
Non-Participating Dentist
Initial Oral Exam 100% $21
Periodic Oral Exam
(Limit 2 per member per year)
100% $15
Emergency Oral Exam 100% $21
Bitewing X-rays - single film 100% $14
Bitewing X-rays - two films 100% $15
Single (periapical) X-rays - first film 100% $11
Single X-rays - additional films 100% $  7
Bitewing X-rays - four films 100% $22
Full mouth X-rays
(Limit one set every 3 years)
100% $51
Routine cleaning
(Limit 2 per adult per year)
100% $33
Basic & Major Dental Care - After the calendar year deductible has been satisfied, benefits are paid according to the following schedules. Although the schedule is the same for both Participating and Non-participating providers, you may experience greater out-of-pocket expense as the negotiated feew do not apply to Non-participating providers. You are responsible for any charges in excess of the stated benefits.
Coverage begins after the policy has been in effect for three continuous months
Basic Dental Care Procedures
Plan Pays
Filling - one surface $  34
Filling - two surfaces $  44
Filling - three surfaces $  58
Filling - four or more surfaces $  67
Extraction - erupted tooth or exposed root $  39
Surgical removal of erupted tooth $  39
Removal of impacted tooth - soft tissue $  94
Removal of impacted tooth - partial bony $127
Removal of impacted tooth - complete bony $168

Coverage begins after the policy has been in effect for twelve continuous months
Major Dental Care Procedures
Plan Pays
Scaling/root planing per quadrant $  38
Gingivectomy - one to three teeth $  33
Gingivectomy - per quadrant (four or more contiguous teeth) $133
Root Canal - 1 canal $133
Root Canal - 2 canals $167
Root Canal - 3 canals $221
Crown (except stainless steel) $244
Pontic $244
Complete denture (upper or lower) $323
Partial denture (upper or lower) $279
Denture reline (chairside) $  67
Denture reline (lab) $  88

  Download Your Dental PPO Brochure  


Anthem Blue Cross Dentist Database

Or you can fill in this form to have your Anthem Blue Cross Senior Dental PPO 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 Senior Dental PPO Insurance Coverage Requested
Our Ages
(over age 65)
  My Age or DOB       Spouse's Age  
People Covered

Customer Information
Full Full Name
Street Address
Zip Code
Home Phone
Work Phone

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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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