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Providers' guide to Oral Health for Overall Health

All BlueDental PPO and Florida Blue Medicare plans include our Oral Health for Overall HealthSM program. Enrolled members receive additional dental benefits that have been shown to improve overall health and lower medical and dental care costs.

These benefits are valued at over $1,000 and are covered 100% with no out-of-pocket expenses when members see a participating provider. Eliminating out-of-pocket costs increases the likelihood of eligible patients taking advantage of the program’s benefits.

Help your patients take advantage of these valuable benefits

We regularly engage enrolled members to make sure they are aware of the relationship between preventive or periodontal dental services and their overall well-being; however, the program has a greater impact when our provider partners participate in member education, so we encourage you and your staff to help your patients understand the value of these important benefits.

Since patients in the program are eligible for four visits per year, we recommend that you schedule all four visits during their first visit.

Eligible
medical
conditions

Periodontal scaling covered
100%

Enhanced cleaning to remove excess plaque buildup

Oral
health screenings; fluoride treatments

Two additional
cleanings or periodontal maintenance visits

Chronic obstructive pulmonary disease (COPD)

Coronary artery disease (CAD)

Diabetes (DM)

End-stage renal disease (ESRD)

Head and neck cancers (HNC)

Metabolic syndrome (MetS)

Oral cancer (OC)

Pregnancy (PG)

Sjogren’s syndrome (SjS)

Stroke (CVA)

Eligible Medical Conditions

Coronary artery disease (CAD)

  • Periodontal scaling covered 100%

  • Enhanced cleaning to remove excess plaque buildup

  • Two additional cleanings or periodontal maintenance visits

Diabetes (DM)

  • Periodontal scaling covered 100%

  • Enhanced cleaning to remove excess plaque buildup

  • Two additional cleanings or periodontal maintenance visits

Chronic obstructive pulmonary disease (COPD)

  • Periodontal scaling covered 100%

  • Enhanced cleaning to remove excess plaque buildup

  • Oral health screenings; fluoride treatments

  • Two additional cleanings or periodontal maintenance visits

End-stage renal disease (ESRD)

  • Periodontal scaling covered 100%

  • Enhanced cleaning to remove excess plaque buildup

  • Oral health screenings; fluoride treatments

  • Two additional cleanings or periodontal maintenance visits

Head and neck cancers (HNC)

  • Enhanced cleaning to remove excess plaque buildup

  • Oral health screenings; fluoride treatments

  • Two additional cleanings or periodontal maintenance visits

Metabolic syndrome (MetS)

  • Periodontal scaling covered 100%

  • Enhanced cleaning to remove excess plaque buildup

  • Two additional cleanings or periodontal maintenance visits

Oral cancer (OC)

  • Enhanced cleaning to remove excess plaque buildup

  • Oral health screenings; fluoride treatments

  • Two additional cleanings or periodontal maintenance visits

Pregnancy (PG)

  • Periodontal scaling covered 100%

  • Enhanced cleaning to remove excess plaque buildup

  • Two additional cleanings or periodontal maintenance visits

Sjogren’s syndrome (SjS)

  • Enhanced cleaning to remove excess plaque buildup

  • Oral health screenings; fluoride treatments

  • Two additional cleanings or periodontal maintenance visits

Stroke (CVA)

  • Periodontal scaling covered 100%

  • Enhanced cleaning to remove excess plaque buildup

  • Two additional cleanings or periodontal maintenance visits

Verifying patient enrollment

Members with Florida Blue health and dental plans and eligible medical conditions affected by oral health are automatically enrolled in the program based on claims information. Members who have only a dental plan are encouraged to self-enroll. Automatic enrollment is key to the program’s effectiveness—it allows us to proactively engage those enrolled so that they understand and use the program’s services.

We recommend you thoroughly review your patients’ medical history before starting treatment. After confirming the condition(s) that led to their enrollment, please call us at 866-445-5148 or review the information on the MyDentalCoverage website. Select the Wellness Benefits tab after logging in through the My Patients’ Benefits link. Their conditions and enrollment date will be displayed—the Limitations column lists which procedures are covered for each qualifying condition.