Could someone knowledgeable about dental insurance please answer a few questions!


Question: Could someone knowledgeable about dental insurance please answer a few questions?
We have Blue Shield of California dental insurance, and on my card it has the name of my dentist. The dentist does a fine job, but her office is now located in an obnoxiously snooty area where you have to valet park and deal with all sorts of nonsense, and they are always pressuring me to get things done that I don't need or overcharging me. For example, I need a mouth guard because I grind my teeth at night, and the one they're insisting I have cost over $1000. I have a horrible habit of misplacing them when I travel, so I really don't want to spend that much money. I know that other places charge way less. I really want to switch to a nice, normal dentist that does a good job and charges reasonable prices.

Can I just go to another dentist? Will it still be covered? I'm under my dad's policy; do I have to get him to do anything?

Answers:

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health-quotes.talk4fun.net - my family have this health insurance. It is affordable and has good coverage for dental issues.



Hi,
Insurance companies generally have a panel of doctors in different regions and states. The name on the card may be a sponsored one. Check with the insurance company about other dentists you can visit in your area. I guess you can do this yourself if you have the details like policy number and the name of the insured.

Practising Dentist



1. BCBS of CA should cover whats called in network and out of network expenses for Dental insurance. You can have your dad log in to BCBSCA.com and see how many dentist are in network and covered under the Dental plan
2. I am sure there are many dentist avail under that plan in your area. You can also call BCBS and get a list of providers in your area
3. You dont need your dad to do anything, just make sure that the dentist you want is " In Network " because it costs less and maybe might be paid at 100.00% by the provider (BCBS)



Just call the number on the back of your card (or your dad's) and ask them this question. They have all the specific information about your insurance and who/what it covers.



It depends on your insurance, BCBS of CA doesn't give quite enough info...

The fact that you say that the doctors name is on the card indicates that you may be on an HMO/DMO plan. If that is the case then no, you cannot just go to another dentist and have it be covered. You have to call into the insurance and request a new dentist. We didn't take any HMO/DMO plans so I don't really know that whole process, just that you'd have to have your dad call in to make that request.

Somewhere on the card you should also see the letters HMO PPO or DMO. If it does say PPO then no you don't need to have your dad do anything. I've linked the provider search feature from the website in my source, pick any dentist you want from there and you will get the in network rates.

If you're still unsure about the PPO/HMO you can also call in to the number on the back of the card. You'll need your policy number, name, and date of birth when you call in, and they'll be able to help you from there.

As for the mouthguard...Broxism is almost never covered at 100%, if you're lucky they'll cover at 50%, most plans simply require that the dentist give you a 20% discount if you're in network and leave it at that. If they were using code 9940 to bill you then we charged about 500 for the mouthguard you're talking about, but the charges depend on a lot of things, like geographic area, lab the dentist uses etc.

To prevent the grinding you can go to walmart and get one of their mouthguards. It'll be about 20 bucks. They don't last for very long and they don't "train" your mouth muscles to keep your teeth apart, but they're cheap and they prevent grinding damage. We used to tell people worried about the price of the guard to give those a shot and then come back if they didn't like them.

You could also get the expensive guard for when you're home and take the cheap walmart one when you travel so that it's not a big deal if you lose it. Your dentist can do a MUCH better job of explaining the difference between the two guards, and why the one he is recommending will do more for you.

https://www.blueshieldca.com/fap/app/sea…

Worked at a dental office doing insurance for two years. We actually worked quite a bit with BCBS of CA.



BS of CA should be able to provide you with a list of participating dentists that you can go to. No insurance company can restrict you to only one dentist to have your work done; you are allowed to go to any dentist you choose that is on their list. This list is usually available online and or you can call any office and sinply ask if the dentist is a "participating doctor" in BS of CA.

DDS (licensed in CA)




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