Anthem BlueCross BlueShield Indiana - Dental Blue Plans
Comprehensive dental benefits for you and your family. Regular dental checkups and cleanings are important to your overall health. They also help you feel better about yourself. That's why they're 100% covered within your plan network by Dental Blue.
No matter which plan you choose, the network will include some of the best dental care around. Dental Blue has thousands of dentists, and every one is a credentialed provider. Also, every contracted specialits (such as oral surgeons and periodontists) can be found in all three Dental Blue network tiers.
3 Plan Designs - With Dental Blue, you have three choices of plan designs. Blue Basic 100, Blue Essential 100 and Blue Essential 200
Save Money with smart network choices
With each Anthem Dental Blue plan, you normally save themost by visiting dentists within your plan's network. If you visit a dentist at a Dental Blue location outside of your network, you still benefit from negotiated rates, though your out-of-pocket depending on the plan and dentist you've chosen.
2 Options to Enroll...
There are two options to enroll in one of the Anthem Dental Plans. The quickest and easiest is to complete the online enrollment form. If you are ready to apply and you want to complete the process online then click the orange button below. You must be 64 years of age or less to use the online application process.
The second option is to download and complete the enrollment form and fax it to us. To choose this option simply download the appropriate enrollment form below. This includes those who are age 65 or older:
DENTAL BLUE PLANS |
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| Blue Basic 100 | Blue Essential 100 | Blue Essential 200 | ALL PLANS | |
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| Adult Rates (19-65) | $17.00 | $20.00 | $28.50 | |
| Child Rates (0-18) | $12.00 | $14.00 | $20.00 | |
| Plan Network | Dental Blue 100 | Dental Blue 100 | Dental Blue 100 & |
Benefit from negotiated rates at Dental Blue providers |
| Preventive and diagnostic care | 100% covered within plan network | 100% covered within plan network | 100% covered within plan network | No waiting period; no deductible in or out of network; covers two routine cleanings and oral exams per year; molar/bicuspid x-rays; full mouth x-rays covered once every 5 years |
| Minor restorative dental care | 80% covered within plan network after $50 deductible** | Pays set amount within plan network and out of network after $50 deductible** | Pays set amount within plan network and out of network after $50 deductible** | No waiting periods |
| Major restorative dental care | Not covered | Pays set amount within plan network and out of network after $50 deductible** | Pays set amount within plan network and out of network after $50 deductible** | 12 month waiting period with Dental Blue Essential plans |
| Annual Maximums | $500 per member | $1,000 per member | $1,000 per member | |
** All deductibles are per member per calendar year Preventive and diagnostic care: Services that help your dentist make sure your teeth and gums are healthy. Routine checkups, cleanings, x-rays, oral evaluations, flouride applications. Basic Plan: filings and space maintainers are included in Minor Restorative dental care; extractions are not covered. Essential Plans: fillings and extractions are included in Minor Restorative dental care; space maintainers are included in Preventive and Diagnostic dental care. Major restorative dental care: Crowns, bridges, root canals and dentures |
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Anthem Blue Cross Blue Shield of Indiana
Dental Blue Application
HOW TO APPLY:
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Select Dental Blue Plan from the brochure available above
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Click on the orange "APPLY ONLINE NOW" button below
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Complete online application. Enrollment effective date is the date after you submit your application unless your request a different date.
If you want a specific effective date please indicate this on your dental application.
Enrolling Online
Enrolling in dental only is easy to do. If you have already determined which Anthem Blue Cross Blue Shield dental plan you are interested in then click on the orange button titled "Apply Online Now" and it will open the Anthem Blue Cross Blue Shield Plan Finder tool. Enter your ZIP code and click NEXT and on the next page enter your information about you as well as family members to be covered. On the next page you can simply click the Dental Plans link and choose the dental plan you want. If you are applying for DENTAL ONLY click the orange "Apply for Dental Only" button at the bottom of the plan choice and you will be directed to an electronic form to complete. It's that easy!
