Emblem Dental Insurance Coverage Options for You

Emblem dental insurance offers a range of coverage options to suit your needs.

You can choose from three different plans: the EmblemSelect plan, the EmblemDirect plan, and the EmblemPlus plan. Each plan has its own unique features and benefits.

The EmblemSelect plan is a great option for individuals who want to customize their coverage. You can choose from a variety of options, including dental and vision coverage.

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We offer five dental plans that cater to different needs and preferences. Our plans are designed to provide flexibility and convenience to our members.

EmblemHealth Preferred Dental is one of our most popular plans, offering a wide network of participating dentists. This plan allows members to seek care from any general dentist or dental specialist without a referral.

We also have a plan specifically designed for those who want more comprehensive coverage, the EmblemHealth Preferred Plus Dental. This plan offers enhanced benefits and a larger network of participating providers.

For those who prefer a more affordable option, we have the EmblemHealth Dental Access Program. This plan provides basic coverage at a lower premium.

Another option is the EmblemHealth Preferred Premier, which offers a higher level of coverage and a wider range of services. This plan is ideal for those who want the best possible dental care.

Lastly, we have the EmblemHealth Spectrum plan, which offers a unique combination of coverage and flexibility. This plan allows members to choose from a range of services and providers.

Here are our five dental plans at a glance:

EmblemHealth has four dental networks that you can participate in, each with its own unique features. Our dental networks consist of over 8,000 dentists and dental specialists practicing in New York and New Jersey.

The networks are: EmblemHealth Preferred Dental, EmblemHealth Preferred Plus Dental, EmblemHealth Dental Access Program, and EmblemHealth Spectrum.

To participate in the Dental Access Program, you must first be part of the Preferred network. Similarly, to join the Spectrum network, you must be a participant of the Preferred network. The Preferred Premier plan also requires participation in the Preferred network.

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You can choose to join one or both of the Preferred and Preferred Plus Networks, which have distinct patient enrollment and reimbursement schedules. Participating in both networks may benefit your practice.

Here's a summary of the networks:

If patients contact your office asking about your participation with EmblemHealth, it's best to ask them which plan they're insured with to determine your participation status. This will help with billing for out-of-pocket expenses.

Emblem dental insurance offers a range of covered services, making it a great option for those looking for comprehensive dental care.

Routine cleanings are covered, with no out-of-pocket costs for members of EmblemHealth VIP Dual Reserve (HMO D-SNP), EmblemHealth VIP Dual (HMO-D-SNP), and EmblemHealth VIP Dual Enhanced (HMO-D-SNP) plans. This includes cleanings every 6 months.

Fluoride applications and x-rays are also covered, with no additional costs for these services.

Fillings are covered every 24 months, with no out-of-pocket costs for members of EmblemHealth VIP Dual Reserve (HMO D-SNP), EmblemHealth VIP Dual (HMO-D-SNP), and EmblemHealth VIP Dual Enhanced (HMO-D-SNP) plans. This includes fillings every 24 months.

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Other covered services include root canals, extractions, and periodontal maintenance, with varying out-of-pocket costs for members of other EmblemHealth plans.

Here's a breakdown of some of the covered services and their associated costs:

These services are a great starting point for understanding what's covered under Emblem dental insurance.