The dental plan is made up of two parts:
- An insured component for covered services
- A discount program component for other services
Covered Dental Services
Under the insured component of the dental plan, covered services at an in-network participating provider will only cost you the copayment.
Covered services are:
- Initial examination, including charting
- Periodic examination
- Cleanings
- Bitewings X-rays
- Filings (two per year)
Dental Discount Card Program
by Anthem Blue Cross
As part of your coverage, you will be enrolled in the Anthem Blue Cross Dental Discount Card Program. Under this program, you will receive preapproved discounted rates for services that are not covered services under the NYS SEHP Dental Plan.
You will not be subject to precertification, eligibility verification or other procedures associated with traditional fee-for-service programs when you utilize the discount program.
When you see an Anthem Discount Card Program participating provider for services not covered under your plan, the participating provider will charge you less than their normal fee. You are required to pay the provider directly for all care you receive.
You will need to see an Anthem Discount Card Program participating provider to get these discounted rates. The dental plan will not provide coverage, reimbursement or discounts when seeing a nonparticipating provider.
To find a provider who is part of the Anthem Blue Cross Dental Discount Cart Program, call 1-833-821-1949
Dental ID Card
You will receive a separate identification card for your dental plan from Anthem Blue Cross. Present this card to your dental provider before receiving services.
Covered Vision Services
Once in a 24-month period (based on your last date of service), you are covered for:
- A routine eye exam
- A limited selection of frames and lenses OR daily wear, disposable or planned replacement contact lenses
These benefits are only available when you visit a participating provider. There is no coverage for services received from a nonparticipating provider.