BlueCare® Dental PPO (DPPO)
BlueCare Dental PPO has one of the largest national networks of general and specialty dentists in both Illinois and nationally, which offers members flexibility in choosing a provider. There are two types of plans offered:
- BlueCare Dental Freedom PPO – Visit any dentist regardless of his or her network participation; covered services are paid at the same level for contracting and non-contracting dentists.
- BlueCare Dental Choice PPO – Save money by visiting dentists within the network; covered services are paid at a higher level for contracting dentists.
In a PPO plan, costs are typically reduced when you receive covered care from network providers. Dentists in the DPPO network have agreed to pre-determined fees for their services. These fees (Schedule of Maximum Allowances), on average, are lower than usual and customary fees. In most cases, BlueCare DPPO provides savings when a network dentist is selected.
You pay less out-of-pocket and contracting providers have agreed not to balance bill. Also, dental specialists can be chosen from the network without a referral for covered services.
One of the many advantages of the BlueCare Dental Preferred Choice plan is its provider network, where you have access to a national network of contracting dentists, and a local network that is one of the largest in Illinois. Members can visit any general or specialty dentist from the network at any time without a referral for covered services.
Dentists undergo credentialing before being accepted into the DPPO network and are re-evaluated periodically.
A complete list of contracting general and specialty dentists can be found online by visiting the Dental Provider Finder® . You can search for a network dentist near your home or office, and conveniently download a map and driving directions. You can also contact customer service at (800) 367-6401 for assistance when selecting a dentist.
Visiting A Dentist
When you visit a BlueCare DPPO contracting dentist, you receive all the advantages your plan offers including the highest available level of benefits. It’s best to confirm the dentist is part of the BlueCare DPPO network when you make your appointment. Remember to present your ID card at your initial visit so the dentist can verify benefits.
If your current dentist is not contracted as a BlueCare DPPO network provider, you can continue to receive care from that dentist, but you may not receive all of the advantages available to you when you use a contracting provider. You also can nominate a dentist to participate in the BlueCare DPPO network by completing the Provider Nomination Form.
Blue Cross and Blue Shield of Illinois is pleased to offer BlueCare Dental ConnectionTM, a proactive approach that protects more than just teeth. BlueCare Dental ConnectionTM provides resources to help encourage you to manage their oral health, which may help improve your overall health.
Research shows a potential link between periodontal disease and other health problems such as heart disease, stroke, diabetes control and premature birth. When it comes to helping you take care of oral health and overall health, administering dental benefits is a starting point. More than ever it’s critical to:
- Apply the knowledge gained from evidence-based dental research
- Create consumer-driven tools specific to dental care and dental benefits
- Use disease management concepts to target members most in need of dental care
BlueCare Dental ConnectionTM includes access to The Dental Wellness CenterTM , a source of online resources and support tools allowing you to:
- Ask licensed dentists dental-related questions through Ask A Dentist
- Locate a network general dentist or specialist with Provider Finder®
- Determine approximate dental fees in the marketplace with the Dental Cost AdvisorTM (requires secure log in to Blue Access for EmployersSM)
In addition, educational information is available on a wide range of dental topics including pediatric care, prevention and dental treatments. You can access the online features of BlueCare Dental ConnectionTM by logging on to Blue Access for MembersSM.