If youre considering dental insurance, you should consider factors such as a plan's provider network, waiting periods and benefit caps. Use your tools to easily find the best plan for you or your entire family. insurance plans or Call anytime to discuss your options with a local, licensed Essence Healthcare advisor. Your dental hygienist will begin your cleaning by exploring the surface of your teeth to determine if you have any cavities and to examine the quality of existing fillings. Other diagnostic radiology services (such as MRI, CT and PET Our office accepts cash, check, Visa, American Express, MasterCard and Discover. Our servers have detected that you are accessing this site from a restricted area. For Essence Health Plan Claims, Eligibility or Patient Referral Inquiries for Arkansas, Georgia, Kentucky, and Ohio plans: 855-425-0457 | customerservice@essencehealthcare.com With my Essence Healthcare plan, I get better coverage at a lower monthly premium than I did when I was working. To what degree does Medicaid provide adult dental coverage? { Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. In addition to great benefits, were committed to delivering maximum value to members by offering comprehensive, affordable Medicare plans with low or no monthly premium, no deductibles and low, predictable copays for doctor visits, hospital stays and prescription drugs.*. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. nearly half To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227 . Typically, dental insurance will not cover dental treatments that are considered essentially cosmetic and not medically necessary. Essence Dental Care - Washington, DC 20020 - Yellow Pages Dental insurance plans typically have deductibles that must be paid before treatment is provided. website and services to function. @media only screen and (max-width: 800px) Learn more about affordable dental insurance options in your state, Copyright 2023 eHealthInsurance Services, Inc. (dba eHealth), Find affordable individual and family health insurance. Please leave a message, and your call will be returned the next business day. We can help you influence star ratings and make your health plan stand out. Its important that you know whether or not your dentist is in-network as choosing an in-network dentist will likely lower your out-of-pocket costs compared to out-of-network providers. Download your FREE Medicare Advantage decision guide or request a copy by mail. }. State Medicaid programs have to cover pediatric dental, but there is wide state-to-state variation in terms of how Medicaid covers adult dental care. If you have not received the code or still have trouble signing in, please call member services. Benefits, star ratings, and network may vary by plan, contract or market. Essence Healthcare Summary of Benefits Things to Know About Essence Advantage, Essence Advantage Plus and Essence Advantage Select Hours of Operation From October 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. Preview the 2023 MA/MAPD products and learn about these portfolio-selling opportunities in your state. These plans, sold directly by dental insurance companies or dental offices, are available year-round. Some states offer emergency-only coverage, while about a third of states provide extensive dental coverage for adults through Medicaid. Phone: 833-994-0637. Before joining the Essence family of companies in 2006, he served as vice president of marketing for e-MDs and held a variety of management positions at several healthcare technology companies, including Trizetto, Nightingale and Mariner Systems. .map_container svg { Fluoride Cleanings. Percentage of ESSENCE Dentists who are listed as "Board Certified" on Doctor.com: 100%. Phone: (202) 610-5696. Using cutting-edge techniques and advanced materials, our office proudly offers you a beautiful, natural smile and all the benefits that come with it. } Sealants last for several years, but will be monitored at your regular checkups. Dental insurance policies often have a waiting period between the coverage start date and the date when certain types of dental work can start. Dr. Zimmerman has a distinguished history of medical leadership at health plans such as CIGNA, Group Health Plan and Health Partners of the Midwest. If you have a dentist preference, make sure that your plan is accepted at the dental practice you prefer. Phone: 855-752-3795. If you already have an account, please log in to receive access to this feature. In 2023, 97% of Medicare Advantage plans provide at least some dental coverage. If a member obtains care from an out-of-network provider without prior approval from Essence Healthcare, Essence Healthcare will not be responsible for the costs. } We sent a one-time security code to {#maskedTwoFactorEmail}. .homepage-new .products_widget { Total number of Dentists on Doctor.com who Accept ESSENCE: Percentage of ESSENCE Dentists who are listed as "Board Certified" on Doctor.com: ESSENCE Dentists listed on Doctor.com have been practicing for an average of: Average ProfilePoints score for Dentists who take ESSENCE: Average Overall User Rating for Dentists who take ESSENCE. If they do not participate in any dental plan networks, they may offer a discount for paying cash or a participation program that you can purchase and then use for discounts on any of the services they provide. Search Prescription Drugs Search our formulary list of covered prescription medications; Find a Doctor Search for primary care physicians, specialists, dentists and more within the Essence Healthcare provider network; Important Plan Documents Find important plan information like Summary of Benefits, Evidence of Coverage, Formulary guides and more Unfortunately, your dental insurance company will only pay for a portion of your dental care and cosmetic procedures like whitening will not be covered. transform: translate(-50%, 0); Compare our plans and see for yourself all that Essence Healthcare has to offer. For example, it may provide free cleanings and exams, but count all other dental services toward the overall medical deductible, which could be several thousand dollars. Essence Dental is HORRIBLE! You must continue to pay your Medicare Part B premium (unless your Part B premium is paid for you by Medicaid or another third party). You may reach a messaging service on weekends from April 1 through September 30 and holidays. height: auto !important; .section_w1280_dental_map { Find plans in your state. Learn more about Essence Healthcare plans at one of our FREE local or online Medicare seminars. Tooth sealants are also recommended because they "seal" the deep grooves in your child's teeth, preventing decay from forming in these hard-to-reach areas. can be prohibitive for dental services consumers. 6509 0 obj <>stream If a family is purchasing coverage through the health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits (premium subsidies). When you're looking for options to replace missing teeth, we offer many choices depending on your individual needs. hOQsLAM` hb6AZ(n-`K`;@|y~nssOp1fyiuL,O|AXWfDS$9[z*'_N9Bk;% #eL2} It is a great idea to learn how dental insurance works to know why prevention and routine dental care is vital. Dental insurance is there to provide you with accessible dental services, such as checkups, cleanings, and dental procedures. Gum disease, injury, and tooth decay all can cause a loss of your natural teeth. 0 Essence Dental Care - 5805 Silver Hill Rd, District Heights, MD 20747 @media( min-width: 800px) and (max-width:1280px ) { You must have both Medicare Parts A and B and Missouri Medicaid with QMB or QMB Plus eligibility to enroll in an Essence Healthcare HMO D-SNP plan. Resources and Downloads. The Affordable Care Act included pediatric dental as one of the laws essential health benefits which means families can buy pediatric dental insurance through their states exchange either embedded in a health insurance plan or through a separate, stand-alone policy. .featured_image_dental_map{ As of 2023, the out-of-pocket cap for pediatric dental services is $375 for one child, and $750 for a family (if there are multiple children on the familys plan). All Essence Healthcare plans include Part D drug coverage. Your child should visit the dentist every six months for regular dental cleanings and checkups. PCPs and Specialists need to ensure all referrals are on file by this date. Enrollment in an Essence Healthcare plan may be limited to specific times of the year. To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. Call anytime to discuss your options with a local, licensed Essence Healthcare advisor. We will work with you and your insurance company to process your claims. } Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. PCPs and Specialists need to ensure all referrals are on file by this date. For most people, achieving a healthy, beautiful smile is the reason for receiving orthodontic care. Need help? Essence Dental Care. This means out-of-pocket costs for pediatric dental care will not exceed $375 per child in 2023 (or $750 for all the children on a familys plan), and there is no cap on medically-necessary pediatric dental benefits (these limits increase to $400 and $800, respectively, in 2024). These limits will increase to $400 and $800, respectively, in 2024. Essence Healthcare includes HMO, HMO-POS and PPO plans with Medicare contracts. width: 100%; Some dental plans include benefits for cosmetic orthodontia services, out-of-pocket cap for pediatric dental services. NEW IN AR, IN, OH, KY & GA! Under pediatric dental coverage obtained via a health insurance marketplace, orthodontia will generally only be covered when considered medically necessary. Specialties. Regular checkups and cleanings now may prevent more serious and costly issues later. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. Essence Dental Care has not yet specified accepted insurance plans. Employer Health Plan Affordability Calculator. Dental insurance is similar to health insurance in that: Dental insurance has long been separate from medical insurance, although employers often offer a benefit package that includes both medical and dental insurance. Heres more about how that works, depending on whether the health plan has integrated pediatric dental benefits. hSkHQ~ien?jX3TZ}.HMrgA/ B9@X#)aPZ~9>ys~ 8 MXeb:L-*vLvb3 ?f9fJ~T/% EpD0L 82&o1Q#|SX*&BP9xiuZk];^e\fSjv|my&91m\HG Others look to stand-alone dental plans some of them specifically designed for seniors. You must continue to pay your Medicare Part B premium. 2023 Essence Healthcare All rights reserved. Exchange-certified stand-alone pediatric dental plans available in your state will comply with the ACAs pediatric dental coverage rules. 44 customer reviews of Essence Healthcare Inc. One of the best Insurance business at 13900 Riverport Dr, Maryland Heights MO, 63043 United States. Dental, vision, and health insurance can be bundled. But assuming you need to purchase your own dental plan, there are several things to keep in mind: Dental plans can be managed care plans (ie, they have a network of participating dentists) or indemnity plans (ie, they pay a set amount for a particular service, regardless of what dentist you use). Essence is making their largest plan growth investments in history. There are plans as low as $10/month, but to have any real coverage for major services, such as crowns and bridges, you should expect to pay at least $35/month. In most states, Medicaid covers at least some dental care for enrollees who are 21 and older. To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. 99. Enrollment in Essence Healthcare depends on contract renewal. } Martha is a talented healthcare executive with more than 25 years of experience in managed care and medical group settings. Mon 9:00 am - 6:00 pm. But its widely available via stand-alone dental plans, either purchased through the exchange or directly from an insurance company. Stay up to date on current COVID-19 guidelines. Y0027_23-1003_C - Last Updated Date: 04/14/2023. You may reach a messaging service on weekends from April 1 to September 30 and holidays. As of 10/15/22 referral requirements will be reinstated. *8 a.m. to 8 p.m., seven days a week. We will estimate your portion and ask you to pay that amount at the time of service. Thu 9:00 am - 6:00 pm. Resources and Downloads. Download your FREE Medicare Decision Guide to compare plans and coststoday. There is no penalty for not having pediatric dental on your policy and in most exchanges, you can purchase a plan without pediatric dental. For people who purchase their own stand-alone dental coverage, premiums are most commonly in the range of $20 to $50 per month. *Plans vary by market. Embedded pediatric dental vs. stand-alone coverage: Pros and cons, Early and Periodic Screening, Diagnostic, and Treatment benefit, Heres an overview of HMO, PPO, EPO, and POS as theyre used for medical insurance, how dental insurance can benefit consumers. Important COVID-19 Information for Essence Healthcare Providers. I refuse to let a doctors or dentist office waste my time. To enroll in an Essence Healthcare plan, you must have both Medicare Parts A and B and reside in the plan service area. Services/Products Dentists. Medicare Supplement Insurance Plans are also known as Medigap, because they cover the "gaps" in Part A and B. One of our goals at Essence Healthcare is to offer comprehensive coverage options to meet the unique needs of every Medicare beneficiary and we achieve this goal by offering our members more choices, more flexibility, more protection and more savings wherever possible.