These plans will vary from state to state in terms of which insurers offer the coverage. The plan will also address major services like implementing dental crowns or other extensive procedures that require more time, effort, and money. Although pediatric dental is one of the ACAs essential health benefits, premium subsidies may or may not be available to help cover the cost of the plan if its purchased as a separate stand-alone coverage. Third Party materials included herein protected under copyright law. Members enrolled in an Essence Healthcare HMO-POS or PPO plan may see out-of-network providers (non-contracted providers). Were excited to announce that Essence Healthcare has added exciting new plan options and expanded its service area for the 2023 plan year to include coverage in a number of new markets including select counties in Northeast Georgia, Ohio, Kentucky, Arkansas, Northern California and Southwest Missouri. Read frequently asked questions about dental insurance. The dental hygienist will then perform a periodontal exam to make sure your gums adhere tightly to your teeth, and no periodontal disease or bone loss may be occurring. To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. If you have a particular dentist you want to keep seeing, youll want to check with them and see if they recommend any particular dental plans. Janae Y. Essence Healthcare 2021 Summary of Benefits Prior to his current role at Essence Healthcare, he was a founder and chief marketing officer for Essences sister company, Lumeris, and also served as president of the companys EHR software division (ClearPractice). } can be prohibitive for dental services consumers. Submission of this form is subject to Healthgrades, Help Millions of people find the right doctor and care they need, Get immediate care and visit with providers from the comfort of your home, or anywhere, Urgent care centers can be faster and cheaper for situations that are not life threatening, Doctors and patients discuss the latest medical treatments and health tips, Search prescription drugs for why theyre used, side effects and more, Back and Neck Surgery (Except Spinal Fusion). Outside of the office, Dr. Zimmerman enjoys traveling especially to visit her three children. Whether youre new to Medicare or already on Original Medicare and growing tired of paying costly premiums for supplemental benefits like prescription drug coverage or vision and dental benefits, you deserve to understand all of your options when it comes to Medicare. Essence provides so much more benefit and at such a low cost. of Americans skip recommended procedures and visits to the dentist due to high cost. Dental managed care plans tend to be HMOs or PPOs (for dental care, these are called DHMOs and DPPOs), but Dental Exclusive Provider Organizations (DEPO) and Dental Point of Service (DPOS) are available in some areas. Essence Healthcare has handpicked some of the areas finest doctors and hospitals to participate in the Essence provider network. Box 5907 Troy, MI 48007, Mailing Address for Customer Service, Claims, Appeals & Grievances: (California plans) P.O. You may reach a messaging service on weekends from April 1 to September 30 and holidays. 5805 Silver Hill Rd Ste G, District Heights MD 20747. position: absolute; top: 0; Pediatric dental is one of the essential health benefits; does that mean my insurance will cover braces for my son? We sent a one-time security code to {#maskedTwoFactorEmail}. More Info Extra Phones. Is there a waiting period for dental insurance? You pay a monthly premium for dental coverage, Your dental plan will typically have a deductible, Your dental plan may have preferred providers, The health insurance marketplace/exchange in your state is a good place to start, particularly if you also need to purchase your own health insurance. %PDF-1.6 % My smile was the envy of all my friends (I also use to model). But the plan may have a waiting period for these services, or may cover a larger percentage of their cost after your plan has been in effect for a certain amount of time. if you are a medicaid customer they will half as do the job, they are only interested in pulling teeth, and then providing dentures to all the medicaid patients. Please note that the Medicare Annual Enrollment Period is October 15th through December 7th. We recommend fluoride treatments twice a year along with cleanings to keep teeth their strongest. 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. Please leave a message, and your call will be returned the next business day. (301) 568-8444. Dr. Zimmerman practiced internal medicine for 15 years and is licensed to practice in Missouri and Illinois. Care Credit has 0% financing with monthly payment options available that can be used for co-payments, deductibles, treatment and procedures not covered by insurance. position: absolute; top: 0; insurance, payment options, etc. You may go to any of our network providers listed in this directory; however, some services may require a . Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. RATINGS AND REVIEWS . Learn more about Medicare Supplement Insurance (Medigap) Plans. Financing | Dental Essence Dental insurance plans start at $8.95/month*. If you happen to have Medicaid coverage, be sure to check your state program to see what sort of adult dental coverage is provided. If your child is eligible for Medicaid or the Childrens Health Insurance Program, the coverage will include dental benefits that are generous and have low out-of-pocket costs. A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994. All other marks contained herein are the property of their respective owners. Click on your state using the map above to learn more. For California providers, as of 11/1/22 referral requirements will be reinstated. Useful 2. La Plata, MD. 2023 Essence Healthcare All rights reserved. It is evident that the individual should prioritize overall care to minimize the need for Tier 2 and Tier 3 level services. There are several tiers in dental insurance; here is an overview of these tiers. Dental X-rays . Please refer to plan documents for additional information or contact Customer Service. Find out how we can help you obtain the best affordable individual and family dental plans today. Members enrolled in an Essence Healthcare HMO or HMO D-SNP plan must use plan providers except in emergency or urgent care situations. Do Not Sell or Share My Personal Information. Its not just Essence Dental Care, its Dr. Patrick Larosiliere who owns this establishment with his wife. Fluoride Cleanings. EHI - SOBEssenceBoone Do ACA marketplace plans include coverage for adults? If youre considering dental insurance, you should consider factors such as a plan's provider network, waiting periods and benefit caps. If you have a dentist preference, make sure that your plan is accepted at the dental practice you prefer. .3b{^I7s6szLH}s"*~=#nb , Understanding how to enroll or anything else in between weve got you covered. Members enrolled in an Essence Healthcare HMO-POS or PPO plan may see out-of-network providers (non-contracted providers). You may find that you can only purchase dental coverage through the exchange if youre also purchasing health insurance. Essence Dental Care is a Practice with 1 Location. dental services. We sent a one-time security code to {#maskedTwoFactorSMS}. Maybe youre unhappy with your current plans customer service. We can bring back the smile on your face with dentures to restore your missing teeth. In fact, a recent survey found that 30% of Americans without dental insurance regretted not being covered. ESSENCE Dentists listed on Doctor.com have been practicing for an average of: 33 year (s) Average ProfilePoints score for Dentists who take ESSENCE: 80/80. 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. Most popular medical specialty of providers who accept ESSENCE: Internist. endstream endobj startxref Invisalign uses a series of invisible, removable, and comfortable aligners that no one can tell you're wearing. If you have access to an employer-sponsored dental plan, that is likely going to provide the best value as your employer will probably subsidize a portion of the premiums. by providers with Doctor.com accounts when editing their profile on Doctor.com. We make it easy for you to get the information you need, when and how you need it. Also delivered quarterly, right to your home! After Dr. Pactrick Larosiliere suggested that I correct a small issue with my teeth., I signed up for ortho care. 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. Martha is a talented healthcare executive with more than 25 years of experience in managed care and medical group settings. Payment method all major credit cards, insurance, paypal, amex, discover, master card, visa Other Link. In 2023, 97% of Medicare Advantage plans provide at least some dental coverage. Dental insurance premiums. Previously, Martha held a number of management positions at Group Health Plan and oversaw the ambulatory surgery department at St. Louis University Hospital. 7,752,060 and 8,719,052. *8 a.m. to 8 p.m., seven days a week. margin: auto; PCPs and Specialists need to ensure all referrals are on file by this date. Under pediatric dental coverage obtained via a health insurance marketplace, orthodontia will generally only be covered when considered medically necessary. height: auto !important; Yes. Find out these and so many more things to be thinking about as you consider a Medicare Advantage plan. (301) 568-8444. As an experienced healthcare executive and certified public accountant, Richard brings more than 30 years of expertise to his current role of president and CEO. Choose how you want to receive or enter your security code. Or perhaps you already have a Medicare Supplement and are tired of paying the expensive premiums and dealing with the hassle of coordinating your Medicare coverage between two companies. Wed 9:00 am - 6:00 pm. 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. Preview the 2023 MA/MAPD products and learn about these portfolio-selling opportunities in your state. 6456 0 obj <>/Filter/FlateDecode/ID[]/Index[6385 125]/Info 6384 0 R/Length 253/Prev 1240540/Root 6386 0 R/Size 6510/Type/XRef/W[1 3 1]>>stream Essence Smiles delivers an anxiety-free dental experience, accepts dental insurance, and offers convenient payment options. In fact, 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 Care in District Heights, MD - WebMD All Essence Healthcare plans include Part D drug coverage. But regardless of whether your dentist is in-network or not, you should always check in advance to see which treatments offered by your dentist are covered by your dental policy. 1576 W Lake St Suite 102, Addison, IL 60101. You are about to be logged out due to inactivity. Call Directions. Initial Organizational and Coverage Determination, Exceptions, Appeals and Grievances, Disenrollment Rights and Responsibilities, Member Notification of Medicare National Coverage Determination.
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