Blue Cross of California Lumenos Plans

Blue Cross of California hit the nail right on the head with their release of the Lumenos plans. These plans speak directly to the healthy individual who seeks an affordable monthly premium with great catastrophic protection.

Preventative care is covered at no charge (provided you see an in-network-provider) making this an ideal option for the individual who rarely sees a doctor but 1-2 times a year. This means you incur no cost for procedures such as annual physical exams (for women this includes pap and mammogram). You can also purchase the Lumenos plans with or without maternity making it flexible for either gender’s needs.

These plans are HSA compatible. With an HSA (Health Savings Account) you can make tax deductible contributions to your account, and withdraw the money tax-free to pay for qualified medical expenses, including prescription drugs. An HSA will help you budget for medical expenses and not be taxed on your savings if you choose to fund them. Please take a look at my post on HSAs to get the full scoop on how they can benefit you.

Lumenos deductible options

• 1500 (3000 family)
• 3000 (6000 family)
• 5000 (10,000 family)

If you would like more detailed information on the Blue Cross Lumenos Plans (including rates) please feel free to contact me!

California Dental Insurance

California dental insurance plans typically offer $500-$1500 in maximum benefit per year. When it pertains to major oral surgeries this does not offer a whole lot of coverage. This is mainly due to the fact that dental insurance in California focuses more on preventative care to “prevent” large dental claims. While it is still better to have a California dental insurance plan than not, it is always wise to evaluate your options before you buy. If you do not understand your options it is best to have a California insurance agent help guide you.

In this blog post I am going to analyze a couple of the larger California dental insurance companies to help you make an informed decision when it comes time to purchase one of their plans. Many people have chosen poorly when it comes to their dental benefits; if you take the time to understand what is covered before you buy then you won’t have any surprises when you receive the first bill from the insurance company.

Today I will be covering California dental plans offered through Blue Cross of California and Delta Dental of California. In my opinion these are the 2 best stand alone carriers that will offer you dental insurance without having to already be enrolled on one of their health insurance plans.

The Dental Blue 100 Basic with Blue Cross of California

With the monthly premium at $20 per individual and $65 per family this California dental insurance plan has some serious value. It is perfect plan for the individual that only sees a dentist twice a year for 2 semi annual routine cleaning visits. With this plan you may seek care with any dentist that is a member of the Dental Blue 100, 200 or 300 Network but the savings will be the best within the 100 Network (contact me for details). You will have a $25 deductible (waived for preventative and diagnostic care if in network) and a $500 annual benefit max per year.

Preventative and Diagnostic Services (covered at 100%)

• Cleanings
• Exams
• X-rays
• Sealants
• Space Maintainers

Basic Services

• Fillings
• Stainless steel crowns for primary (baby teeth) and pulpotomies

Unfortunately there is no coverage for major services and Orthodontics under the Dental Blue 100 Basic plan but you will still receive a negotiated fee discount if you undergo major services with a Dental Blue provider (for more information on this please contact me).

Major Services Include

• Oral Surgery
• Endodontics
• Crowns (for adult teeth)
• Prosthodontics

If you require more care than the Dental Blue 100 Basic can offer you will most certainly want to take a look at the 3 other Dental Blue plans available. The Dental Blue 100 Plus, Dental Blue 200 Plus and the Dental Blue 200 essential will all cover major services but the waiting periods (the time you must be active on the plan before you can receive coverage benefits) range from 6 months to a year (please contact me for full details).

DeltaCare USA program with Delta Dental of California

The DeltaCare USA plan is an HMO program that provides comprehensive dental care (both preventative care and major services). It is a great match for someone that does not have a current dentist because it does not work like a PPO network. The HMO network is of course much more limited than the PPO but the coverage is much richer. There are no waiting periods and no coverage limit! Most PPO dental plans have a $1000 maximum benefit making the DeltaCare HMO plan a very wise choice provided you can find a close provider in your area of residence (for help locating your closest dental care facility please contact me).

What do the premiums look like?

• For a single individual you will pay an annual fee of $97 plus a one time enrollment fee.

• Enrollee plus dependent $155 ($15 one time fee)

• Enrollee plus 2 or more dependents $225 ($15 on time fee)

Like the Dental Blue 100 Basic, preventative and diagnostic care are covered at no charge. There are many different major services which of course you will pay a specific co-pay amount. For more information on this please contact me and I will email (or mail) you a free brochure that describes the DeltaCare HMO in full detail.