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Complete Application

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Anthem Blue Cross - California
Individual & Family
Dental PPO, HMO & New Dental Blue Plans

Timothy Jennings

It's All About Simplicity

Blue Cross Dental RatesNow you have more choices for your Dental coverage. Anthem Blue Cross and Anthem BC Life & Health now offer three plan designs and 8 plan choices. Three of the four choices are Anthem Blue Cross Dental SelectHMOSM plans. These plans require you to use participating dentists and vary primarily in the amount they pay for restorative services. In all  three plans, you pay only $5 per office visit for exams, cleanings and x-rays. There are no annual deductibles, no annual maximums and no waiting periods for most services.

The Dental Blue Plans from BC LIfe & Health offer you an affordable PPO solution to meet your dental needs - all designed to give you the power to choose. Dental Blue give you two networks - Dental Blue 100 and 200, four plans at several price points. Whether you choose a Dental Blue 100 or Dental Blue 200 plan, you have the power to visit any dentist or specialist in either of the two networks.

The PPO Dental Plan (from BC Life & Health Insurance Company) allows you to see any dentist you choose. However, using a Blue Cross PPO participating dentist saves you money because  there’s no charge for preventive and diagnostic services and you’re assured that the dentist will charge no more than the Blue Cross-negotiated fees. Note that the PPO plan does not cover orthodontia.

Who’s Eligible for Blue Cross Dental Plans 

Lumenos Health PlansYou and your dependents must be California residents. If you enroll in one of the Blue Cross Dental SelectHMO plans, you and your dependents must select the same participating dental office. Dental providers and locations are different for the Dental PPO and Dental SelectHMO.  Eligible dependents include:

  • Your lawful spouse
  • Any unmarried child under age 19 of you or your enrolled spouse
  • Any unmarried child, age 19 to 23, of you or your enrolled spouse, who qualifies as a dependent  for federal income tax purposes
  • A child of you or your enrolled spouse, who continues to be both incapable of self- support, due to  continuing mental retardation or physical handicap, and who is at least one-half dependent on you or your spouse for support.

Anthem Blue Cross - California Dental Brochure and Application

Below are the three color brochures and links to the applications for the Individual Dental plans from Blue Cross of California. To apply for coverage simply download, print, complete and Mail the application with payment to the address below:Credit Card Authorization Form

HOW TO APPLY:

  1. Select Dental Plan from the plans below
  2. Download & Print the correct application file
  3. Download Credit Card Authorization form to the right
  4. Complete the applications and FAX to (415) 651-8696

MAILING ADDRESS

Application Processing
P O Box 180761
Coronado, CA 92178

If you wish to expedite your application for coverage you need to download the Credit Card Authorization form by clicking on the image to the right. Then fax your completed dental application and authorization form to FAX# 415-651-8696. If you want a specific effective date please indicate this on your fax cover sheet or somewhere on the application.

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BC Life Dental Blue Brochure

DENTAL BLUE PPO for INDIVIDUALS & FAMILIES

Top 6 Reasons to Choose Dental Blue
All Dental Blue Networks Offer:

  • 18,000+ dental professionals to choose from - the largest PPO network in California
  • No deductibles for cleanings, exams and X-rays
  • No claim forms or paperwork to deal with
  • Discounts on popular services like teeth whitening, implants and braces
  • Access to Dental specialists without referrals
  • Discounted fees even after members reach their annual maximum benefit
  • Download BC Life & Health Dental Blue PPO Brochure Here
  • Download BC Life & Health Dental Blue PPO Application Here
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Blue Cross of California Dental PPO
INDIVIDUAL DENTAL PPO PLAN

Unique benefits of the Anthem Blue Cross Individual Dental PPO Plan from BC Life & Health include:

  • Freedom to choose any dentist but save with a dentist in network
  • Receive a wide range of dental and specialty services
  • Access quality care at discounted fees from their large network of more than 12,000 professionals, with a low $50 annual deductible
  • Blue Cross is a name you can trust as they have been an industry leader in California for more than 65 years
  • Healthy Extensions Program gives you information about discounts of 10-50% offered by independent vendors on related products
  • Choose as a stand alone plan or in combination with any Blue Cros health coverage that you are purchasing or already have
  • Download Blue Cross of California Dental PPO Brochure Here
  • Download Blue Cross of Califrnia Dental PPO Application Here
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Blue Cross of California Dental HMO

DENTAL SELECTHMO PLAN

Anthem Blue Cross HMO Dental Plans offer:

  • More choices - three HMO plans and a large network of dentists to choose from
  • Comprehensive benefits - a broad range of preventive, basic and major services
  • Specialty services - orothodontic and cosmetic
  • Affordable monthly rates p choice of payment options with low $5 office visit fees for exams, cleanings and X-rays
  • Download Blue Cross of California Dental SelectHMO Brochure Here
  • Download Blue Cross of Califrnia Dental SelectHMO Application Here
P O Box 6374 Jackson Hole, WY 83002-6374
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