The most your plan will pay for services in a plan year.
Coinsurance
The percentage of costs you pay for care and services after you meet your deductible.
Copay
The set amount you pay for each dental service at the time of your visit.
Deductible
The amount you may need to pay before your plan starts helping withcosts.
Exclusions
Certain services or procedures that may be excluded from your dental coverage, such as cosmetic procedures.
In-network
Dental care providers who have agreed to offer discounted rates on products and services to those with certain dental plans. You will often pay less out of pocket when you visit a dentist in your plan’snetwork.
Limitations
Coverage or age limits your dental plan places on certain services or procedures.
Premium
The amount paid either by you or your employer for your dental plan each month. This amount may be automatically deducted from your paycheck.
Waitingperiod
A set period of time that must pass before you can receive coverage for certain dental procedures. Waiting periods may vary based on your plan.
Know your dental plan’s vocabulary
Annual maximums
Annual maximums
Coinsurance
Coinsurance
Copay
Copay
Deductible
Deductible
Exclusions
Exclusions
In-network
In-network
Limitations
Limitations
Select each term for the definition.
Premium
Premium
Waiting period
Waiting period
With coinsurance, your plan pays a certain percentage of the cost for services and then you’re responsible for paying the rest. Most Preferred Provider Organization (PPO) dental plans use what we call a 100/80/50 structure for coinsurance coverage. With this structure, when you visit a dentist in your plan’s network, the plan covers:
of the cost for preventive care, including cleanings, exams, and X-rays.
of the cost for major procedures like crowns or dentures.
50%
Keep in mind, the coverage details discussed here are only examples. Please check your individual plan details for exact coverage information.
Regular at-home oral health habits and preventive dental visits can help you avoid visits for problem care, more invasive procedures, and additional fear altogether.
Roll over each tip for more information.
6 tips to cope with a fear of the dentist
6 tips to cope with a fear of the dentist
Staying on top of your oral health
Staying on top of your oral health
Choose the next dot for details on preventive dental care.
Delta Dental website: What is preventive dental care? (accessed August 2023): deltadental.com. Cleveland Clinic website: Dental Cleaning (accessed August 2023): my.clevelandclinic.org. Centers for Disease Control and Prevention website: Oral Health Tips (accessed August 2023): cdc.gov.
Sydney Health is offered through an arrangement with Carelon Digital Platforms, a separate company offering mobile application services on behalf of your health plan.
Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
1055697CAMENABC 07/23
Your dental health is important. Use the SydneySM Health app or visit anthem.com/cato find dental coverage details specific to your plan and access digital tools like the Dental Cost Estimator.
Orthodontia
Coverage for orthodontic services, like braces and other alignment devices, varies by plan type.
Coverage amounts shown are based on seeing a dentist in your plan’s network. Be sure to check your plan details for more information on your specific coverage.
Do you need to schedule a virtual dental care appointment now?
The Ask a Hygienist feature can help you get answers to your dental care questions before your next visit. You can also complete the online Dental Health Assessment to learn more about your dental health.
Preventive and diagnostic
Most dental plans cover preventive and diagnostic services at 100%, including:
X-rays
Cleanings
Routine exams
Fluoride treatments
.
.
.
.
Basic
Basic dental services are typically covered at 80% by most plans. These services mayinclude:
Fillings
Simple extractions
.
.
Major
Many dental plans help cover major dental services at 50%. Major services mayinclude:
Crowns
Root canals
Dentures
.
.
.
100%
80%
It’s your mouth’s time to shine
Learn more about dental health and your benefits below
Preventive visits allow your dentist to check for signs of disease that may show up in your mouth.
Regular cleanings help prevent bad breath by removing the tartar and plaque on yourteeth.
Routine visits could help you save money by giving you and your dentist a chance to stop more expensive dental issues before theystart.
Regular preventive visits can help reduce your risk for the followingconditions:
Toothsensitivity
Recedinggums
Gumdisease
Toothdecay
4 benefits of regular preventive visits
A routine cleaning and exam typically take 30 to 60 minutes and usually includes scaling (to remove plaque and tartar) and polishing. Then, depending on your needs, other preventive and diagnostic services like fluoride treatments, sealants, or X-rays may berecommended.
Your dentist will also talk with you about what they find during their exam and discuss your treatment options for any issues, asneeded.
What to expect during a routine dental visit
The best way to save money on dental care and keep your mouth healthy is to regularly practice preventive care at home. The habits below don’t take much time and can have a big impact on your overallhealth.
Brush at least twice aday.
Floss daily between allteeth.
Manage chronic conditions, like diabetes, as they can cause oral health issues.
Limit sugary foods andbeverages.
Avoid smoking or using tobaccoproducts.
Visit your dentist for a routine visit at least twice ayear.
At-home prevention tips
Preventive/diagnostic
Preventive services help your dentist monitor your oral health and work with you to promote healthy habits, prevent disease, and catch signs of problems early. Preventive dental careincludes:
Diagnostic services
Regularcleanings
Fluoridetreatments
Sealants
Restorative
If your dentist notices an issue during a preventive visit, you may need to stay longer, return later, or see a specialist to treat the problem. Restorative appointments may take longer than normal, and you may need time to recover afterward, so keep that in mind if you’re able to plan for them in advance. Restorative care services mayinclude:
Fillingcavities
Root canaltherapy
Crowns
Extractions
Emergency
Emergency dental care may be necessary when there is unexpected trauma to your mouth or if you’re experiencing severe pain and discomfort. Your dentist can help you determine whether you can wait to be seen during regular office hours, or if you need to see a virtual dentist or visit an emergency dentist. Call them as soon as possible in the followingsituations:
Infection
Trauma
Severe toothpain
A chipped or fracturedtooth
Talk to people you trust.
Talk to people you trust.
Ask them for dentist recommendations or find out what they like about their dentist. Their experiences can help you choose a dentist you feel comfortable with.
Visit a dentist virtually.
Visit a dentist virtually.
Ask your regular dentist if they offer virtual visits so you can be evaluated from home. You can also visit the Teledentists for urgent or emergency virtual dental care.
Try torelax.
Try to relax.
Talk to your dentist and their staff about how to stay relaxed during your visits or procedures. It’s likely that you are not their only patient with a fear of dental visits, so they may be able to share useful tips.
Ask questions.
Ask questions.
Knowing the details of any recommended or scheduled procedures, including routine cleanings, can help you avoid surprises and put your mind at ease.
Talk about your concerns.
Talk about yourconcerns.
Communication is key. Speak with your dentist and their staff about your fears so they can try to make you as comfortable as possible during your visits.
Research dentists online.
Research dentistsonline.
Use the Find Care feature on our website to find quality dentists in your plan’s network. You can learn more about a specific dentist, their office, and their staff by visiting their website before making an appointment.