Premera Blue Cross, a leading health insurance provider in the Pacific Northwest, offers extensive dental coverage options for individuals, families, and Medicare Advantage members. Understanding the network of dental providers and the benefits available is crucial for maximizing your dental health coverage.
Understanding Premera’s Dental Network
Premera’s dental network includes a wide range of providers across Washington and Alaska. Members can access general dentists, specialists, and orthodontists within this network. To find an in-network dental provider, members can use the Find a Doctor tool on Premera’s website.
Dental Coverage Options
Individual and Family Plans
Premera offers dental plans that cover preventive services like cleanings and exams, as well as basic and major services such as fillings, crowns, and root canals. These plans are designed to provide comprehensive dental care for individuals and families.
Medicare Advantage Plans
For Medicare Advantage members, Premera provides dental benefits that include preventive and comprehensive services. However, it’s important to note that Premera will exit the Medicare Advantage market as of January 1, 2025. Members should verify their dental coverage and seek assistance if needed. citeturn0search7
Accessing Dental Services
Members can access dental services by presenting their Premera ID card at participating dental offices. It’s advisable to confirm the provider’s network status before scheduling an appointment. For services requiring prior authorization, such as certain surgeries or orthodontic treatments, members should consult Premera’s guidelines or contact customer service.
Submitting Dental Claims
Dental providers typically handle claim submissions on behalf of members. For services rendered by out-of-network providers or in cases where members pay upfront, claims can be submitted to Premera for reimbursement. Detailed instructions and necessary forms are available on Premera’s Dental Resources page.
Finding In-Network Dentists
To locate in-network dental providers:
- Visit the Find a Doctor tool.
- Enter your location and select “Dentist” under the provider type.
- Review the list of available in-network dental providers in your area.
Premera Blue Cross offers a robust network of dental providers and comprehensive coverage options to meet the diverse needs of its members. By understanding your plan’s benefits and utilizing in-network providers, you can effectively manage your dental health care.