Above for quotes Nationwide

Below form is for California only

Anthem Blue Cross of California Dental Insurance 
(877)566-5454 Toll Free
Anthem Blue Cross OF CALIFORNIA INDIVIDUAL DENTAL PPO HIGHLIGHTS
PREVENTIVE & DIAGNOSTIC CARE
(No waiting periods & deductible is waived at Participating Dentists)
 
At a Participating Dentist
At a Non-Participating Dentist
We pay:
We pay:
Periodic oral exams   100% $18
Comprehensive oral exam 100% $25
Bitewing X-rays single film 100% $16*
Bitewing X-rays two films 100% $18*
Single (Periapical) X-rays first film 100% $13*
additional Films 100% $8*
Bitewing X-rays four films 100% $26*
Full mouth X-rays one set every 3 years 100% $60
Routine cleaning adult: two per year 100% $39
child: two per year 100% $30
Cleaning with fluoride child: two per year 100% $35
Topical fluoride only child: two per year 100% $14
BASIC DENTAL CARE
(3 month waiting period)
 
At a Participating or
Non-Participating Dentist, we pay:
Filling 1 surface/2 surfaces/3 surfaces/4 or more surfaces $42/$55/$72/$84
Extraction of erupted tooth or exposed root single tooth/each additional tooth $49
Extraction surgical removal of erupted tooth $84
Extraction of impacted tooth soft tissue/partial bony/complete bony $111/$148/$180
MAJOR DENTAL CARE
(12 month waiting period)
 
At a Participating or
Non-Participating Dentist, we pay:
Scaling/Root planning per quadrant $48
Gingivectomy 1 to 3 teeth per quadrant $40
Gingivectomy 4 or more contiguous teeth per quadrant $145
Osseous Surgery 4 or more contiguous teeth or bounded teeth spaces per quadrant $277
Root canal 1 canal/2 canals/3 canals $154/$189/$242
Inlay 1 surface/2 surfaces/3 surfaces $172/$198/$220
Onlay in addition to inlay $57
Crown non-stainless steel/stainless steel $264/$57
Pontic   $264
Post and Core in addition to crown $75
Dentures complete upper or lower $343
partial upper or lower $308
reline chairside $75
reline lab $106
Annual maximum benefit $1,000 per member
Annual deductible $50 per person (3 family member max)

* Total benefit for single and bitewing X-rays not to exceed cost of full mouth -- $60 at non-participating dentists.

  Download Your Dental PPO Brochure/Application  

DOWNLOAD YOUR DENTAL PPO APPLICATION

Anthem Blue Cross Dentist Database

Call us Toll-free at 1-877-Look4Life (1-877-566-5454) for pricing or you can fill in this form to have your Anthem Blue Cross Dental Insurance brochure with pricing & application mailed to you. Further information on our plans is shown below.
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Barricks Insurance Services
13900 NW Passage #302, Marina Del Rey, CA 90292
Phone:   (310) 827-7286    |   Fax:   (310) 827-0256
Toll-Free 1-877-Look4Life  (1-877-566-5454)

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