Changing from Delta Dental to Anthem for Dental Coverage

• How do I check to see if my dentist is in the Anthem-Dental Complete Network?

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  To see if your current dentist is in the network go to:

  1. Visit: https://www.anthem.com/find-care
  2. Select “Basic search as guest”
  3. Under select the type of plan or network, choose "dental plan or network"
  4. Under Select the state choose Indiana
  5. Under Select a plan/network choose "Dental Complete".  Hit Continue button
  6. Search based on type of provider or facility, locations near you or by a provider’s name
  7. View our results and find out about the providers training, languages spoken, location and phone number

   

  If you have trouble navigating the search tool, call 1-877-604-2142

• What if I do not find my dentist in the search tool?

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  Call your dentist office and confirm whether they are in the Anthem-Dental Complete Network. This is also your opportunity to ask them if they would consider exploring joining the Anthem-Dental network.

• My Dentist is not in the Anthem-Dental Complete Network. Now what?

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  While The Heritage Group dental plans provide adequate coverage for out-of-network services, we encourage you to find an in-network provider, when possible, to ensure you are receiving the best possible coverage available through the insurance network from a financial perspective and to avoid any additional billing that can result when going out-of-network.

  However, we also encourage you to contact your dentist directly and understand how your dentist has worked with patients in similar circumstances in the past. You can ask them to have a better understanding of cost to expect to be billed for services. You can also ask them to consider joining the Anthem-Dental Complete Network. We encourage you to start these conversations sooner rather than later, so you have time to find a new provider and get in their scheduling queue.

  While Anthem will be proactively reaching out to ask your dentist to join the network, we also encourage you to complete the provider nomination form linked here to begin the nomination process.

  Download Provider Nomination Form

• Why am I at risk for being billed directly from the dentist when using an out-of-network Dentist?

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  Unlike in-network dentists, out-of-network dentists may send you a bill and collect for the charge that exceeds Anthem’s Maximum Allowed Amount. You are responsible for paying the difference between the Maximum Allowed Amount and the amount charged. This amount may be significant. Choosing a Participating In-Network Dentist will likely result in lower out of pocket costs to you.

  Anthem Customer Service is available to assist you in determining the Maximum Allowed Amount for a particular service from a Non-Participating Dentist. For Anthem to assist you, you will need to obtain the specific procedure code(s) from your Dentist for the services the Dentist will render. You will also need to know the Dentist’s charges to calculate your out-of-pocket responsibility. Although Customer Service can assist you with this pre-service information, the Maximum Allowed Amount for your claim will be based on the actual claim submitted by the dentist.

• Will I need to present an insurance card when going to the dentist?

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  Yes, with Anthem you will be required to share your card at point of service. You will receive a new card in the mail from Anthem in the coming months. If you are on the medical plan, you will get a combined medical/dental card.  If you take dental ONLY, you will receive an Anthem card for dental.   Anthem’s cards are sent in an unmarked envelope.

• Where can I find out what is covered under the new plans?

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  While dental plan deductibles, annual plan maximums, in-network and out-of-network cost share remain unchanged, there are a few changes with the new plans with Anthem. For a comprehensive list please refer to the Summary and Certificate Documents.

• How are my current and historical orthodontia benefits impacted?

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  The lifetime maximum amount of 50% up to $1500 for orthodontia coverage for dependents up to age 19. If you are currently in treatment for orthodontia services and have not yet met the lifetime maximum allowed amount you will be eligible for the remaining balance under the Anthem plan. If you have already met the ortho maximum, you will not be newly eligible under the Anthem plan. For more information on specifics of orthodontia coverage view this resource.