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Get Medicare Vision and Dental Plans for Seniors in California.

woman considering Medicare supplement dental plans

Dental plan and package options

Blue Shield offers a variety of dental plans for Medicare Supplement plan members.

Two different types of dental PPO plans are available. Plus, our dental and vision plan package, Specialty Duo,*,1 provides even more coverage.

Good reasons to enroll

Dental health insurance plan advantages:

  • An extensive network that includes 335,107 dentists nationally and 52,889 dentists in CA.2
  • 1 cleaning every 4 months, plus annual X-rays and oral cancer screening covered at 100% when using network providers.3
  • No waiting period for dental checkups, cleanings, fillings, X-rays, or basic services.
  • Wide range of major restorative dental services and procedures, including crowns, endodontics, periodontics, oral surgery, and prosthetics.4

Specialty Duo dental + vision package advantages:

  • Includes all dental benefits of the Dental PPO 1500 Plan
  • Access to more than 6,700 ophthalmologists, optometrists, opticians and retail stores in California, and over 25,000 nationwide.2
  • $0 copayment for eye exams
  • $25 copayment for lenses and low vision-aids
  • $100 frame allowance that can be used toward any pair of frames
  • Benefit for plano non-prescription sunglasses for members who have had LASIK or PRK surgery

Affordable dental plan rates

Effective April 1, 2018

Dental PPO 1000
Dental PPO 1500
Specialty Duo
dental + vision
package*,1
Individual
$40.70
$49.80
$61.90


With each of these plans, you can visit any dentist. However, your out-of-pocket costs will be lower if the dentist is within a network.

Dental PPO highlights and summary

Dental PPO 1000
Dental PPO 1500
Calendar-year deductible
(per member)
$75 / person
$50 / person
Calendar-year benefit maximum
$1,000
($750 may be used for
Non-network dentists)6
$1,500
($1,000 may be used for
Non-network dentists)6
Blue Shield pays
Blue Shield pays
Diagnostic and preventive care
(not subject to plan deductibles
with network dentists; includes
routine oral exams, X-rays,
and three teeth-cleanings annually)
100% for Network dentists
50% for Non-network
dentists7
100% for Network dentists
80% for Non-network
dentists7
Basic services
(includes anesthesia, palliative
treatment, and restorative dentistry)
50% for Non-network
dentists7
80% for Network dentists
70% for Non-network
dentists7
Major services4
12-month waiting period
(includes crown buildups, crowns,
endodontics, periodontics, oral
surgery, prosthetics, inlays, onlays,
jackets, post and cores, and veneers)
50% for Non-network
dentists7
50% for Non-network
dentists7

Specialty Duo dental + vision Package

Want convenience? Specialty Duo combines the benefits of the Dental PPO 1500 plan with vision benefits.

With this package, you’ll have the freedom to choose the providers of your choice. Plus, you can access some of the largest vision and dental networks in the state. (Bear in mind, your costs will be lower by visiting network providers.)

Duo Vision plan highlights and summary

Service and eyewear
Coverage when provided
by network providers
Coverage when provided
by non-network providers
Comprehensive examination
— every 12 months
$75 / person
$50 / person
Opthalmologic
100%
up to a maximum of $60
Optometric
100%
up to a maximum of $50
Lenses8,9
- every 24 months (or 12 months
with a prescription change)
Single vision
100%
up to a maximum of $43
Bifocal
100%
up to a maximum of $63
Trifocal
100%
up to a maximum of $75
Aphakic or lenticular monofocal
100%
up to a maximum of $120
Aphakic or lenticular multifocal
100%
up to a maximum of $200
Frames — every 24 months
up to a maximum of $10010
up to a maximum of $40
Contact lenses9,11
- every 24 months (or 12 months
with a prescription change)
Non-elective (medically necessary)12
Hard
100%
up to a maximum of $200
Soft
100%
up to a maximum of $250
Elective contact lenses
(cosmetic/convenience)
up to a maximum of $120
up to a maximum of $120
Plano (non-prescription) sunglasses11,13
up to a maximum of $10010
Not covered

Become a Member Today!

Sign up for a Blue Shield dental plan or Specialty Duo dental + vision package on the Medicare Supplement application.

Current Medicare Supplement plan members can sign up through the dental enrollment application.

If you have questions, contact your Blue Shield agent.

You can find a dentist and vision care provider online. Or for a list of providers in your area, contact Member Services at (888) 679-8928.

* Underwritten by Blue Shield of California Life & Health Insurance Company (Blue Shield Life).

1 Specialty Duo package includes both Specialty Duo dental plan and Specialty Duo vision plan for Medicare Supplement plan members.

2 Dental providers in and out of California are available through a contracted dental plan administrator. Vision providers in and out of California are available through a contracted vision plan administrator.

3 The 1 in 4 month cleaning benefit is available with the Dental PPO 1000, Dental PPO 1500 and Specialty Duo Dental plan for Medicare Supplement plan members.

4 Dental PPO 1000, Dental PPO 1500 and Specialty Duo Dental plan for Medicare Supplement plan members have a 12-month waiting period for major restorative services and procedures (such as crowns), endodontics, periodontics, oral surgery, and removable or fixed prosthetics.

5 If you have a two-party Medicare Supplement plan contract, you and your spouse/domestic partner must both select and enroll in the same dental PPO plan or dental + vision package in order to receive one bill that combines Medicare Supplement plan with dental PPO plan or dental + vision package rates.

6 Each calendar year, the member is responsible for all charges incurred after the plan has paid these amounts for covered dental services.

7 The coinsurance percentage indicated is a percentage of allowed amounts that we pay to providers. Non-network providers can charge more than our allowable amount. When members use non-network providers, they must pay the applicable copayment/coinsurance plus any amount that exceeds our allowable amount. Charges in excess of the allowable amount do not count toward the calendar-year deductible or copayment maximum.

8 Each pair of lenses includes a pink or rose tint No.1 or No. 2 in the allowance and up to 61mm in size.

9 A prescription change means any of the following: a change in prescription of 0.50 diopter or more; a shift in axis of astigmatism of 15 degrees; a difference in vertical prism greater than 1 prism diopter; or a change in lens type.

10 When the participating provider uses wholesale or warehouse pricing, the maximum allowable frame allowance will be as follows: wholesale allowance − $66.04; warehouse allowance − $69.09. Note that this pricing replaces the frame allowance shown in the Summary of Benefits. Network providers using wholesale or warehouse pricing are identified in the Directory of Network Vision Providers. You pay any cost above the allowed amount.

11 In lieu of lenses and frame.

12 A report from the provider and prior authorization from a contracted vision plan administrator is required.

13 For members who have had PRK, LASIK, or custom LASIK vision correction surgery only, this benefit of plano sunglasses allowance is equal to the plan's frame allowance. An eye exam by a network provider is required to verify laser surgery or a note from the surgeon who performed the laser surgery is required to verify laser surgery. Available once every 24 months.

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