Do you already have a Medicare Advantage plan, but youre in the market for a better option? Phone: 855-752-3795. 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. .map_heading .heading_pals .map_alternate img You may reach a messaging service on weekends from April 1 to September 30 and holidays. (630) 250-0333 | 28 reviews of Essence Dental Care "My opinion this dental office is the worse, I will never go back or recommend them to anyone. Find an Essence Healthcare Provider - Essence Healthcare Specialties. No matter where you are on your Medicare journey, understanding all of your options is key in choosing the right plan for you. Every year, Medicare evaluates plans based on a 5-star rating system. Services. Weve also added additional service counties across the Greater Saint Louis Metropolitan area. 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. If youre new to Medicare, well help you make sense of your options so you can feel confident youre choosing the right plan. 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). As is the case for allessential health benefits, the specific coverage requirements for pediatric dental care are guided byyour states essential health benefits benchmark plan. Costs vary depending on your provider and the level of coverage outlined by each plan. { 6385 0 obj <> endobj Access the 2023 Plan Previews Today Introducing 2023 Essence Healthcare First Looks! To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227 . Essence Healthcare | Medicare Supplement Insurance Plans (Medigap Y0027_23-1003_C - Last Updated Date: 04/14/2023. In 2023, 97% of Medicare Advantage plans provide at least some dental coverage. Dental Emergencies. One child was called back but had not been seen and my other child still waiting they signed in together with the same appt time. Each type of plan functions differently and is designed to help you get the most out of your Medicare coverage. 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. Many plans will also pay some of the cost of more extensive dental work, such as root canals, crowns, endodontics, and periodontics. View all Cisco Systems jobs - Bengaluru jobs - Software Engineer jobs in Bengaluru, Karnataka Martha is a talented healthcare executive with more than 25 years of experience in managed care and medical group settings. In addition to great benefits, were committed to delivering maximum value to members by offering comprehensive, affordable Medicare plans with low or no monthly premium, no deductibles and low, predictable copays for doctor visits, hospital stays and prescription drugs.*. Search our formulary list of covered prescription medications, Search for primary care physicians, specialists, dentists and more within the Essence Healthcare provider network, Find important plan information like Summary of Benefits, Evidence of Coverage, Formulary guides and more, View additional information and resources on Essence Healthcare Medicare Advantage plans, Find out how Essence has grown to be a leading local and national Medicare provider over the past 15 years, Hear what members have to say about Essence Healthcare. Beware that he has more than 1 location. (In states that use HealthCare.gov as their exchange, its not possible to buy just a dental plan without a health plan, but federal legislation has been introduced in 2023 that would change that rule.). Payment is expected at the time of service. }. DentaQuest delivers concierge-level service, flexible cost-effective dental plan designs, and access to a scalable provider network for Medicare Advantage health plans. Depending on what areas youre hoping to improve upon, we help boil things down into an easy-to-consume format and summarize all of the aspects youll want to be looking at this time around to ensure you select the right plan for you. Essence Healthcare Summary of Benefits Things to Know About Essence Advantage, Essence Advantage Plus and Essence Advantage Select Hours of Operation From October 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. State Medicaid programs have to cover pediatric dental, but there is wide state-to-state variation in terms of how Medicaid covers adult dental care. We make it easy for you to get the information you need, when and how you need it. Services/Products Dentists. See how dental insurance options vary depending on where you live. Heres more about adult dental coverage through the marketplace: In most cases, if youre shopping outside of open enrollment, youll need to search for a dental plan name you recognize or a site that offers dental plan comparisons. Get all your questions answered in a one-on-one appointment with a licensed Medicare advisor. We use cookies and limited processing of your personal information for our Sealants last for several years, but will be monitored at your regular checkups. Choose how you want to receive or enter your security code. If you have a dentist preference, make sure that your plan is accepted at the dental practice you prefer. All Essence Healthcare plans include Part D drug coverage. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. In every part of the country, pediatric dental coverage has to be made available through the exchange either as a stand-alone plan or integrated with the health plans that are available to families. Preview the 2023 MA/MAPD products and learn about these portfolio-selling opportunities in your state. please contact Essence Healthcare Customer Service at 1-866-597-9560 (TTY: 711), 8 a.m. to 8 p.m., seven days a week. Please provide your zip code to see plans in your area. .map_svg_wrapper @media( min-width: 800px) and (max-width:1280px ) { This can be in addition to your plans regular deductible. Use your tools to easily find the best plan for you or your entire family. Unfortunately, your dental insurance company will only pay for a portion of your dental care and cosmetic procedures like whitening will not be covered. She has served companies in all aspects of audit service delivery and related audit and financial reporting matters, including coordination and execution of financial statement audits, review and supervision of staff accountants, and documentation and testing of business processes and internal controls. } Dental insurance can be an affordable solution for those looking for regular and preventative coverage. More than 70% of orthodontists in the US and Canada are certified to treat with Invisalign. 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. PCPs and Specialists need to ensure all referrals are on file by this date. If you were to need these services, you would have to share these costs with your insurer, in many cases, and would have considerable financial outlays. .3b{^I7s6szLH}s"*~=#nb , Diagnostic procedures and tests: 20% co-insurance. These are usually comprehensive plans, meaning that medical, dental, health, disability and life could all be provided to employees of a company. I refuse to let a doctors or dentist office waste my time. Essence Healthcare includes HMO, HMO-POS and PPO plans with Medicare contracts. position: relative; No matter what youre hoping to find in your next plan, we can help. Address: 1576 W Lake St Suite 102, Addison, IL 60101, 1576 W Lake St Suite 102, Addison, IL 60101. Very pro.peopleThere, Address: 2345 Martin Luther King Jr Ave SE, Washington, DC 20020, Website: http://www.essencedentalcare.com, 300 D St SW Ste 211, Washington, DC 20024, 2811 Pennsylvania Ave SE Ste 2, Washington, DC 20020, 490 Lenfant Plz SW Ste 8210, Washington, DC 20024, 908 New Hampshire Ave NW, Ste 100, Washington, DC, DC 20037, 908 New Hampshire Ave NW Ste 301, Washington, DC 20037, 2231 Crystal Dr Lbby 150, Arlington, VA 22202, 919 18th St Nw Suite Lower Level 52, Washington, DC 20006. When looking at dental health coverage options, it is necessary to understand these critical components. The content on Healthgrades does not provide medical advice. NEW IN AR, IN, OH, KY & GA! Fluoride Cleanings. Every year, Medicare evaluates plans based on a 5-star rating system. Fri 9:00 am - 3:00 pm. . Dental insurance policies often have a waiting period between the coverage start date and the date when certain types of dental work can start. 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). 2023 Essence Healthcare All rights reserved. These plans will vary from state to state in terms of which insurers offer the coverage. Visit Essence Smiles in Queens, NY ig1 !G[UPh?k^CJ8G]L CTvRIetF!!"(ur*I`&mOkwG~,@>(jh3TAy3H@ApP"!K$l0(qX!DfH+`"sID" " sm'IOz 8Sa?` C } Learn about the key differences between Essence Healthcare and other Medicare plans. If a family is purchasing coverage through the health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits(premium subsidies). 7,752,060 and 8,719,052. width: 78%; We will estimate your portion and ask you to pay that amount at the time of service. Essence Healthcare - Provider Directory - Provider Pharmacy Directory position: absolute; This means out-of-pocket costs for pediatric dental care will not exceed $375 per child in 2023 (or $750 for all the children on a familys plan), and there is no cap on medically-necessary pediatric dental benefits (these limits increase to $400 and $800, respectively, in 2024). Does dental insurance cover cosmetic treatments and procedures? Why Choose Essence Healthcare Medicare Advantage. 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. Accepted Insurance. From 2000 to 2005, she served as executive director of Esse Health, one of the nations largest independent physician groups. There are plans as low as $10/month, but to have any real coverage for major services, such as crowns and bridges, you should expect to pay at least $35/month. 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 Learn more about Essence Healthcare plans at one of our FREE local or online Medicare seminars. When it comes to switching to an all-in-one Medicare Advantage plan from Original Medicare, theres a lot of new to consider. Martha is a native St. Louisan, has three grown children and currently lives in the St. Louis area with her husband. This can either be via pediatric dental benefits being embedded in the health plan, or you can attest that you have pediatric dental coverage from another source, such as a stand-alone plan. 0. Fax: (301) 568-8447. Find out these and so many more things to be thinking about as you consider a Medicare Advantage plan. They really take care of me. Compare plans or request your FREE, no-obligation Medicare Decision Guidetoday! { ESSENCE providers listed on Doctor.com have been practicing for an average of: 27.3 year (s) Average ProfilePoints score for Providers who take ESSENCE: 52/80. Learn more about Essence Healthcare plans at one of our FREE local or online Medicare seminars. Currently, I have three teeth missing that is very visible. You may go to any of our network providers listed in this directory; however, some services may require a . ProfilePoints measure the overall completeness of a can be prohibitive for dental services consumers. Dental health is strongly tied to your overall health. We offer a broad range of plans to meet your dental needs, both big and small. Weve outlined all of the details youll want to compare when considering a switch from another Medicare Advantage provider to an Essence Healthcare plan. Pediatric dental is one of the essential health benefits, although its a bit more complicated than the other nine. Heres more about how that works, depending on whether the health plan has integrated pediatric dental benefits. There are plans as low as $10/month, but to have any real coverage for major services, such as crowns and bridges, you should expect to pay at least $35/month. Need help? width: 100%; Essence Dental Care has not yet specified any specialties. With Essence Healthcare emails, you can opt out at anytime and well never sell or share your information with anyone. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. This content is not available in your current region. Don't second guess, just run and research another dentists! To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. In essence, the basic component will focus on more routine dental services. For adults, dental coverage is rarely embedded in medical plans. More Info Extra Phones. Financing | Dental Essence Here's what you need to know when you're shopping for adult dental coverage through a state health insurance marketplace or directly from a dental plan carrier. We will estimate your portion and ask you to pay that amount at the time of service. understand that the Resend, Mailing Address for Customer Service, Claims, Appeals & Grievances: (Arkansas, Georgia, Illinois, Kentucky, Missouri, and Ohio plans) P.O. Now that Im retired, thats very important. We accept all PPO dental insurance plans and as a courtesy, we will file your dental insurance claim for you. 0 Dental insurance is there to provide you with accessible dental services, such as checkups, cleanings, and dental procedures. Medicare Supplement Insurance Plans are also known as Medigap, because they cover the "gaps" in Part A and B. Learn more about affordable dental insurance options in your state, Copyright 2023 eHealthInsurance Services, Inc. (dba eHealth), Find affordable individual and family health insurance. Funny. we make it easier for you to quickly identify the most informative profiles on Doctor.com. Download your FREE Medicare Advantage decision guide or request a copy by mail. If you are looking to learn more about dental coverage, have questions about dental coverage, or want to select an ideal dental plan for you and your family, our dental health experts at eHealth can assist. Joel is a seasoned executive with over 22 years of experience in the healthcare industry. All Essence Healthcare plans include Part D drug coverage. .image img But that only applies to stand-alone dental plans that are purchased in the exchange/marketplace. However, we want to remind you that your policy is an agreement between you and your insurance company. Our New to Medicare resources offer everything you need to help you make an informed decision from start to finish. We can help you influence star ratings and make your health plan stand out. .featured_image_dental_map{ } Some states require all health plans to embed pediatric dental, while other states rely on stand-alone dental plans to provide this coverage. But its widely available via stand-alone dental plans, either purchased through the exchange or directly from an insurance company. Phone: 833-994-0637. endstream endobj 6386 0 obj <>/Metadata 321 0 R/Outlines 704 0 R/Pages 6378 0 R/StructTreeRoot 764 0 R/Type/Catalog>> endobj 6387 0 obj <. From 2000 to 2005, she served as executive director of Esse Health, one of the nations largest independent physician groups. If a member obtains care from an out-of-network provider without prior approval from Essence Healthcare, Essence Healthcare will not be responsible for the costs. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. This dentist lacks empathy and compassion and your children deserves a better doctor! Previously, Martha held a number of management positions at Group Health Plan and oversaw the ambulatory surgery department at St. Louis University Hospital. Essence Advantage (HMO) Diagnostic Services/Labs/Imaging (Costs for these services may vary based on place of service) Lab services: $20 copay. To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. transform: translate(-50%, 0); Essence Dental Care - 5805 Silver Hill Rd, District Heights, MD 20747 While it may be tempting to forgo the extra costs of dental insurance, you might face more significant dental health problems and have extensive financial outlays in the future. They also tend to have benefit caps that limit how much the insurance plan will pay for adult dental care. If youre new to Medicare and arent sure where to begin or where to turn next on your journey to Medicare, check out our New to Medicare resources for helpful guidance. website and services to function. If you're an adult who bought a dental insurance plan, your out-of-pocket costs will depend entirely on the amount of dental care you need during the year. Phone: (202) 610-5696. provider's profile, including items like having a photo, a biography, More Info Extra Phones. If you see the name Larosiliererun. When a plan has a cap on how much it will pay, there is no limit to how high your out-of-pocket costs can be for adult dental care (this is the opposite of how most medical insurance plans work, as they will generally cap how much you pay, rather than how much the plan will pay). } Ive never seen anybody come close to that before. Your privacy is important to us. In most states, Medicaid covers at least some dental care for enrollees who are 21 and older. Call anytime to discuss your options with a local, licensed Essence Healthcare advisor. Dental insurance coverage options will largely fully take on the costs of the Tier 1 procedures, will provide a large . Dental Fillings. The appt was made 3 months ago. Dr. Zimmerman has a distinguished history of medical leadership at health plans such as CIGNA, Group Health Plan and Health Partners of the Midwest. Tue 9:00 am - 6:00 pm. Will dental insurance cover services provided by my dentist? If a family is purchasing coverage through the health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits (premium subsidies). Plus, Zoom! Outside of the office, Dr. Zimmerman enjoys traveling especially to visit her three children. 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. } Before joining Essence Healthcare, she served as chief medical officer of Mercy Health Plans, a providersponsored plan owned by Sisters of Mercy. These investments will [] For more information or assistance, please call Customer Service at the number listed under the Contact Us page. Medicare can be complex, but it doesnt have to be confusing. Stay up to date on current COVID-19 guidelines. (301) 568-8444. At eHealth, we aim to make it as simple as possible for you to obtain dental care options that help you to lower the cost of overall dental care. There are several tiers in dental insurance; here is an overview of these tiers. 5805 Silver Hill Rd, District Heights, MD 20747. Third Party materials included herein protected under copyright law. Let us help you achieve your smile goals! Listened & answered questions. For most people, achieving a healthy, beautiful smile is the reason for receiving orthodontic care. Essence Dental Care - District Heights, MD 20747 - Yellow Pages where consumers can shop for dental coverage in the U.S. how much dental insurance might cost you and. Essence Dental Care - Washington, DC 20020 - Yellow Pages Sign up for email or text appointment reminders. Adult dental insurance coverage, however, is not required or regulated under the ACA. Learn more atwww.CareCredit.com. Gum disease, injury, and tooth decay all can cause a loss of your natural teeth. Enrollment in Essence Healthcare depends on contract renewal. Search Prescription Drugs Search our formulary list of covered prescription medications; Find a Doctor Search for primary care physicians, specialists, dentists and more within the Essence Healthcare provider network; Important Plan Documents Find important plan information like Summary of Benefits, Evidence of Coverage, Formulary guides and more You must have both Medicare Parts A and B and Missouri Medicaid with QMB or QMB Plus eligibility to enroll in an Essence Healthcare HMO D-SNP plan. Benefits, star ratings, and network may vary by plan, contract or market. .section_w1280_dental_map { With the simple click of a mouse, our secure online service allows you to: View your appointment and account information any time. .map_container svg hOQsLAM` hb6AZ(n-`K`;@|y~nssOp1fyiuL,O|AXWfDS$9[z*'_N9Bk;% #eL2} He obtained his Doctor of Dental Surgery degree and a certificate in orthodontics from Howard University. In most states, Medicaid covers at least some dental care for enrollees who are 21 and older, although several states limit this coverage to emergencies. X-rays: $20 copay. Zoom! dental services. Check your payment history and see current charges. Dental Insurance Benefit Solutions | Dental Insurance Benefits Thats the case in all states that use HealthCare.gov as their exchange, although federal. Essence Healthcare Summary of Benefits. This is part of the Medicaid programs Early and Periodic Screening, Diagnostic, and Treatment benefit, which is required to be provided in all states for Medicaid enrollees under the age of 21. Examples might include an extraction prior to radiation treatment for oral cancer, or jaw reconstruction following an accident. Some states offer emergency-only coverage, while about a third of states provide extensive dental coverage for adults through Medicaid. The plan will also address major services like implementing dental crowns or other extensive procedures that require more time, effort, and money. Medicare Advantage Plans | Essence Healthcare She is also an accomplished entrepreneur, having co-founded a successful disease and complex case management firm. Currently Essence Dental Care's 16 physicians cover 5 specialty areas of medicine. group dental insurance plans, you can do so through eHealth. Benefits vary by plan. You are about to be logged out due to inactivity. Many seniors who dont have dental coverage from a former employer or through a spouses employer turn to Medicare Advantage. As of 10/15/22 referral requirements will be reinstated. The treatment is safe, simple, and relaxing! You should consider your oral health needs to determine what type of plan is right for you and your budget. All other marks contained herein are the property of their respective owners. If they do not participate in any dental plan networks, they may offer a discount for paying cash or a participation program that you can purchase and then use for discounts on any of the services they provide. width: 100%; Please refer to plan documents for additional information or contact Customer Service. Erin brings over a decade of public accounting experience to Essence Healthcare, with nine years focused on the insurance industry serving life, health, property/casualty insurers, captive insurers and reinsurers. Dental X-rays . My story is too long to tell but I never write reviews but I wouldn't wish my experience on my enemy. width: 135% !important; No matter where you are on your Medicare journey, understanding all of your options is key in choosing the right plan for you. 9AM - 5PM. If youre considering dental insurance, you should consider factors such as a plan's provider network, waiting periods and benefit caps. Percentage of ESSENCE Dentists who are listed as "Board Certified" on Doctor.com: 100%. It is a great idea to learn how dental insurance works to know why prevention and routine dental care is vital. Some medical policies have pediatric dental embedded in the plan, and Our state guides offer up-to-date information about ACA-compliant individual and family plans and marketplace enrollment; Medicaid expansion status and Medicaid eligibility; short-term health insurance regulations and short-term plan availability; and Medicare plan options. Essence Healthcare Medicare Advantage Plans with Part D and please don't take your children there. *8 a.m. to 8 p.m., seven days a week. Oral health doesn't have to be costly. She is also an accomplished entrepreneur, having co-founded a successful disease and complex case management firm. 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. If a member obtains care from an out-of-network provider without prior approval from Essence Healthcare, Essence Healthcare will not be responsible for the costs. Home > 2023 guide to dental insurance plans. You may reach a messaging service on weekends from April 1 through September 30 and holidays. 1/18/2018 . Enrollment in Essence Healthcare depends on contract renewal. Compare our plans and see for yourself all that Essence Healthcare has to offer. Search our formulary list of covered prescription medications, Search for primary care physicians, specialists, dentists and more within the Essence Healthcare provider network, Find important plan information like Summary of Benefits, Evidence of Coverage, Formulary guides and more, View additional information and resources on Essence Healthcare Medicare Advantage plans, Find out how Essence has grown to be a leading local and national Medicare provider over the past 15 years, Hear what members have to say about Essence Healthcare, Just starting to explore coverage options, Determining when youre eligible to enroll. Essence Dental Care. All Essence Healthcare plans include Part D drug coverage. Anytime you dont use an in-network dentist (including any care you receive if you have a dental indemnity plan), your dentist can bill you for any amount of their charges that are above the reasonable and customary fee that the dental plan is willing to pay. Invisalign uses a series of invisible, removable, and comfortable aligners that no one can tell you're wearing. Essence Dental Care has not yet specified accepted insurance plans. Call Directions. Consumer demand for dental insurance in the U.S. is on the rise, and its increasing due to a growing prevalence of tooth decay as well as an increased awareness about the importance of oral hygiene. But assuming you need to purchase your own dental plan, there are several things to keep in mind: Dental plans can be managed care plans (ie, they have a network of participating dentists) or indemnity plans (ie, they pay a set amount for a particular service, regardless of what dentist you use). Dental insurance can also lower your costs while helping you prevent dental hygiene problems that can impact your overall health. You may find that its worthwhile to pay a larger premium in order to have more extensive coverage (ie, a larger benefit cap) or a shorter waiting period for certain services. Invisalign is made with 3D computer imaging technology and has been proven effective. Under pediatric dental coverage obtained via a health insurance marketplace, orthodontia will generally only be covered when considered medically necessary.

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