Blue Cross/Blue Shield
Thanks to our advanced software programs and vast experience of our insurance coordinators, we can help you use your dental insurance to cover most or all of the costs for your care.
This is a brief description of common terms and conditions found in most Blue Cross / Blue Shield Dental PPO plans.
Many Westchester dentists accept Blue Cross / Blue Shield Dental.
Few of them do as much as we to save you money.
With us, you get maximum benefit from your insurance – THIS IS HOW!
Empire Blue Cross/Blue Shield offers a wide variety dental insurance plans, and the type of plan you have depends on the contract your employer signed with them. Many of the plans follow similar structure – but yours may have specific conditions and exclusions not found in any other.
Annual Maximum Benefit –
Is what your insurance will pay in any given insurance year. For Empire Blue Cross/Blue Shield, it is typically between $1500 and $2500. Most Empire Blue Cross/Blue Shield Plans define INSURANCE YEAR from January 1 to December 31. Some plans, especially for school employees, may run on July 1-June 30 year. Check with your plan.
Annual Deductible –
what your insurance plan wants you to pay before they cover anything. For Empire Blue Cross/Blue Shield, it is usually $50.
Coverage for Preventive procedures – what your insurance plan will pay for checkups, cleanings, X-rays, and sealants and fluoride for children. It is typically 100%, although some plans may pay less. Usually, the deductible does not apply.
Coverage for Basic procedures – what your insurance plan will pay for fillings, root canals, gum treatments, and extractions. Most Empire Blue Cross/Blue Shield plans will cover 60-80% of the procedure costs. Sometimes, even though the plan says they will cover 80% of the procedure, their fees are so low that the actual coverage may be less.
Coverage for Major Procedures –
crowns, bridges, dentures. Typically, it is 50%, but it is subject to many provisions and restrictions, such as missing tooth clause, alternative minimum benefits, and others.
Coverage for Cosmetic Procedures –
veneers, teeth whitening, cosmetic bonding, adult orthodontics. No Empire Blue Cross/Blue Shield plan we have seen provides any coverage for these procedures.
Coverage for Dental Implants –
varies greatly by the plan. Check with your carrier for specific information.
Please keep in mind that your plan may be completely different from the general guidelines we have provided here. We use a sophisticated computer system, Dentrix with Trojan Insurance Module, to help us get as much information as possible. Very often, we are able to tell you about your plan in great detail once we know who the employer is. Call us at 914 630 2833 for more information.
Some of the companies and organizations in and around Westchester County who offer Empire Blue Cross/Blue Shield Dental PPO to their employees and members are:
Dental B. Fund Electric
Montefiore Medical Center
Social Security Admin.
Class Action Management Inc
Dental Benefit Fund Of The Elec