please contact Essence Healthcare Customer Service at 1-866-597-9560 (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This dentist lacks empathy and compassion and your children deserves a better doctor! is championed by dentists and patients as a pain-free process. } See how dental insurance options vary depending on where you live. (917) 285-2644. If you have a dentist preference, make sure that your plan is accepted at the dental practice you prefer. Dental insurance is there to provide you with accessible dental services, such as checkups, cleanings, and dental procedures. You must be logged in to access this feature. how you can find affordable coverage that fits your budget and needs. 6385 0 obj <> endobj 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. { 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 For plans with Part D Coverage: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. And it will probably cover a portion of the cost of fillings and extractions after your deductible is met. Dental insurance coverage options will largely fully take on the costs of the Tier 1 procedures, will provide a large portion of assistance for the Tier 2 procedures and then provide a portion of financial assistance for Tier 3 services. Resources and Downloads. ProfilePoints measure the overall completeness of a Find out how we can help you obtain the best affordable individual and family dental plans today. You may find that you can only purchase dental coverage through the exchange if youre also purchasing health insurance. As of 10/15/22 referral requirements will be reinstated. 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. Benefits, star ratings, and network may vary by plan, contract, or market. Note that if you purchase a family dental plan outside the exchange, it does not have to comply with the ACAs rules for pediatric dental coverage, which means it will be able to limit how much the plan will pay for dental care, for both children and adults. Learn more about affordable dental insurance options in your state, Copyright 2023 eHealthInsurance Services, Inc. (dba eHealth), Find affordable individual and family health insurance. Dr. Zimmerman has a distinguished history of medical leadership at health plans such as CIGNA, Group Health Plan and Health Partners of the Midwest. 5. But there tend to be a lot of similarities in terms of the coverage thats offered on the available plans. 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. is a professional teeth whitening treatment that gets your teeth an average of eight shades whiter in just one hour. Dental insurance premiums. Humana Medicare Advantage Plans. Doctor.com specializes in matching patients with the health care .featured_image_dental_map{ No matter where you are on your journey to Medicare, you want to be sure youre always up to speed on the most up-to-date content with regards to popular Medicare topics that could potentially affect you or your plan. Gum disease, injury, and tooth decay all can cause a loss of your natural teeth. Average Overall User Rating for providers who take ESSENCE: 5 (out of 5) .homepage-new .products_widget { For individuals, dental insurance costs typically range between $16 and $70 per month. of Americans skip recommended procedures and visits to the dentist due to high cost. endstream endobj startxref 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. Specialties. My smile was the envy of all my friends (I also use to model). Please, I beg you, educate yourself on dental/orthodontist care and Never Never go to him or his wife. Before joining Essence Healthcare, she served as chief medical officer of Mercy Health Plans, a providersponsored plan owned by Sisters of Mercy. Payment method all major credit cards, insurance, paypal, amex, discover, master card, visa Other Link. When youre comparing dental plans, pay close attention to things like waiting periods (generally only required for major services), deductibles, benefit caps, and monthly premiums. She has extensive expertise in process improvement, health center administration facilities management, and information systems operations. Click on your state using the map above to learn more. All Essence Healthcare plans include Part D drug coverage. 0 Cool. 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. (301) 568-8444. Martha is a native St. Louisan, has three grown children and currently lives in the St. Louis area with her husband. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. 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. group dental insurance plans, you can do so through eHealth. 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. Dental health insurance plans will have two categories, basic and major components. Essence Dental Care has not yet specified any specialties. %PDF-1.6 % Enrollment in Essence Healthcare depends on contract renewal. We make it easy for you to get the information you need, when and how you need it. But that only applies to stand-alone dental plans that are purchased in the exchange/marketplace. For Americans who purchase their own stand-alone dental coverage, premiums are most commonly in the range of $20 to $50 per month. It is a great idea to learn how dental insurance works to know why prevention and routine dental care is vital. } Business health insurance. Enrollment in an Essence Healthcare plan may be limited to specific times of the year. 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. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227 . Weve also added additional service counties across the Greater Saint Louis Metropolitan area. .map_container svg { Essence Healthcare includes HMO, HMO-POS, and PPO plans with Medicare contracts. Do Not Sell or Share My Personal Information. cost of dental insurance plans We can bring back the smile on your face with dentures to restore your missing teeth. { Find out how Medicare Advantage compares to Original Medicare. 5805 Silver Hill Rd Ste G, District Heights MD 20747. Dr. Zimmerman practiced internal medicine for 15 years and is licensed to practice in Missouri and Illinois. Embedded pediatric dental vs. stand-alone coverage: Pros and cons, Early and Periodic Screening, Diagnostic, and Treatment benefit, Heres an overview of HMO, PPO, EPO, and POS as theyre used for medical insurance, how dental insurance can benefit consumers. Dental, vision, and health insurance can be bundled. top: 0; 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. The treatment is safe, simple, and relaxing! Dental coverage: What to expect from Medicare, your states essential health benefits benchmark plan. Dental coverage leads to earlier and better dental care. .map_container svg Call Directions. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. We can make no guarantee of any estimated coverage made by your insurance company, but we will see that you receive your maximum benefits. But its widely available via stand-alone dental plans, either purchased through the exchange or directly from an insurance company. position: absolute; Other diagnostic radiology services (such as MRI, CT and PET 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. You should consider and anticipate specific coverage needs for yourself and each member of your family when choosing the right plan. This can be in addition to your plans regular deductible. can be prohibitive for dental services consumers. Check your payment history and see current charges. However, we want to remind you that your policy is an agreement between you and your insurance company. Typically, dental insurance will not cover dental treatments that are considered essentially cosmetic and not medically necessary. Dental Fillings. Essence Dental Care is a Practice with 1 Location. .section_w1280_dental_map { We can help you find a Dentist who accepts ESSENCE in your area. Use your tools to easily find the best plan for you or your entire family. My story is too long to tell but I never write reviews but I wouldn't wish my experience on my enemy. @media( min-width: 800px) and (max-width:1280px ) { display: block !important; 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 <. Members enrolled in an Essence Healthcare HMO or HMO D-SNP plan must use plan providers except in emergency or urgent care situations. More than 70% of orthodontists in the US and Canada are certified to treat with Invisalign. Yes. Will dental insurance cover services provided by my dentist? Didn't receive a code? Pediatric dental is one of the essential health benefits; does that mean my insurance will cover braces for my son? 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. padding: 40px 0 40px; No matter where you are on your Medicare journey, understanding all of your options is key in choosing the right plan for you. 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. With my Essence Healthcare plan, I get better coverage at a lower monthly premium than I did when I was working. 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). Need dental coverage? For pediatric dental treatment, however, those are reversed if you buy a stand-alone dental plan through the exchange in your state: out-of-pocket costs are limited, and insurance benefits (the amount the insurance company will pay) are unlimited. 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. Not to mention, I paid for 80% of the services up front. All other marks contained herein are the property of their respective owners. From 2000 to 2005, she served as executive director of Esse Health, one of the nations largest independent physician groups. .map_container svg Cox HealthPlans Medicare Advantage. } { Dental Cleanings. Third Party materials included herein protected under copyright law. 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. Essence Dental Care. 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. The core idea here is that if individuals practiced the right behaviors, ate the right foods, and visited their dentists regularly for basic procedures, they would have lower chances of needing more extensive restorative procedures. You must continue to pay your Medicare Part B premium. A trusted independent health insurance guide since 1994. 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. So, you can smile more during treatment as well as after. In her role at Essence, Erin provides strategic vision and oversight to the compliance and internal audit functions of the company. } eHealth has been able to focus on the needs of the health-conscious consumer over the past 25 years. 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). You must continue to pay your Medicare Part B premium (unless your Part B premium is paid for you by Medicaid or another third party). By providing cosmetic dental care, your dentist is able to offer smile enhancement, restoration, and maintenance treatments for optimal dental health. 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. we make it easier for you to quickly identify the most informative profiles on Doctor.com. 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. If you happen to have Medicaid coverage, be sure to check your state program to see what sort of adult dental coverage is provided. All Essence Healthcare plans include Part D drug coverage. . If youre considering dental insurance, you should consider factors such as a plan's provider network, waiting periods and benefit caps. Outside of the office, Dr. Zimmerman enjoys traveling especially to visit her three children. Our office accepts cash, check, Visa, American Express, MasterCard and Discover. Benefits, star ratings, and network may vary by plan, contract or market. No matter what your Medicare coverage looks like today, well help you make sense of the differences between Original Medicare and Medicare Advantage plans and provide you with a checklist of key considerations along with a comprehensive list of questions you should be asking to ensure you make the best-possible decision as you consider an all-in-one Medicare Advantage plan. The plan addresses basic needs like regular cleanings, root canals, or even fillings. PCPs and Specialists need to ensure all referrals are on file by this date. To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. Although Original Medicare is administered by the federal government, Medigap plans are offered by health insurance companies approved by the federal government. 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. Find Reviews, Ratings, Directions, Business Hours, Contact Information and book online appointment. After Dr. Pactrick Larosiliere suggested that I correct a small issue with my teeth., I signed up for ortho care. Dental insurance is generally available through the health insurance marketplace, but only during open enrollment or a special enrollment period, and often only in conjunction with an ACA-compliant health plan. Funny. Employer Health Plan Affordability Calculator. Language assistance services are available, free of charge. This is more in line with the way health insurance works. .3b{^I7s6szLH}s"*~=#nb , width: 135% !important; We use cookies and limited processing of your personal information for our Address: 1576 W Lake St Suite 102, Addison, IL 60101, 1576 W Lake St Suite 102, Addison, IL 60101. All Rights Reserved. All Essence Healthcare plans include Part D drug coverage. Essence Dental Care. PCPs and Specialists need to ensure all referrals are on file by this date. insurance, payment options, etc. Phone: (202) 610-5696. More. You are about to be logged out due to inactivity. Tue 9:00 am - 6:00 pm. Why Choose Essence Healthcare Medicare Advantage. .image img Each type of plan functions differently and is designed to help you get the most out of your Medicare coverage. Please leave a message, and your call will be returned the next business day. Percentage of ESSENCE Dentists who are listed as "Board Certified" on Doctor.com: 100%. NEW IN AR, IN, OH, KY & GA! A native of Columbia, Missouri, Erin and her family enjoy all things Mizzou sports. Wed 9:00 am - 6:00 pm. Visit Website. Out-of-network providers are under no obligation to treat Plan members, except in emergency situations. Average Overall User Rating for Dentists who take ESSENCE: width: 100%; These dental coverage plans help lower dental care costs so that you can go for visits without having to incur significant financial burdens. More Info Extra Phones. 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. Using cutting-edge techniques and advanced materials, our office proudly offers you a beautiful, natural smile and all the benefits that come with it. Useful 2. Learn more atwww.CareCredit.com. Please work with your PCP to ensure all necessary referrals are in place. If youre buying a health plan that has embedded dental coverage (fairly common for children, but not particularly common for adults), be sure you understand how the coverage works. Please provide your zip code to see plans in your area. Heres more about how that works, depending on whether the health plan has integrated pediatric dental benefits. { 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. 44 customer reviews of Essence Healthcare Inc. One of the best Insurance business at 13900 Riverport Dr, Maryland Heights MO, 63043 United States. The appt was made 3 months ago. transform: translate(-50%, 0); Out-of-network providers are under no obligation to treat Plan members, except in emergency situations. 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. If youre new to Medicare, well help you make sense of your options so you can feel confident youre choosing the right plan. and please don't take your children there. You must continue to pay your Medicare Part B premium (unless your Part B premium is paid for you by Medicaid or another third party). Please refer to plan documents for additional information or contact Customer Service. 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. If you're self-conscious about your smile, correcting your concerns with braces will greatly improve the way you look and feel. Some dental plans include benefits for cosmetic orthodontia services, although this is more common for employer-sponsored dental plans than self-purchased dental plans. We will estimate your portion and ask you to pay that amount at the time of service. Adult dental insurance coverage, however, is not required or regulated under the ACA. Learn about the key differences between Essence Healthcare and other Medicare plans. 6509 0 obj <>stream Always consult a medical provider for diagnosis and treatment. 99. . You may reach a messaging service on weekends from April 1 to September 30 and holidays. Is it better for me to pay out of pocket for dental care and not worry about dental insurance? Essence Dental Care has not yet specified accepted insurance plans. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. Every year, Medicare evaluates plans based on a 5-star rating system. Sign up for email or text appointment reminders. 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. Out-of-network providers are under no obligation to treat Plan members, except in emergency situations. Thats the case in all states that use HealthCare.gov as their exchange, although federal. 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. Call anytime to discuss your options with a local, licensed Essence Healthcare advisor. 28 reviews of Essence Dental Care "My opinion this dental office is the worse, I will never go back or recommend them to anyone. 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. (301) 568-8444. Services/Products Dentists. left: 50%; For people who purchase their own stand-alone dental coverage, premiums are most commonly in the range of $20 to $50 per month. Dental insurance is often provided in conjunction with vision insurance, with both types of care covered under a single plan. Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. To enroll in an Essence plan, you must have both Medicare Parts A and B and reside in the plan service area. Find out these and so many more things to be thinking about as you consider a Medicare Advantage plan. Members enrolled in an Essence Healthcare HMO-POS or PPO plan may see out-of-network providers (non-contracted providers). Dr. Patrick Larosiliere is an orthodontist. Compare plan options for individuals and families. 2023 Essence Healthcare All rights reserved. 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. Some dental plans include benefits for cosmetic orthodontia services, out-of-pocket cap for pediatric dental services. DentaQuest delivers concierge-level service, flexible cost-effective dental plan designs, and access to a scalable provider network for Medicare Advantage health plans. (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.). }Iv])r6=Z:*b]s6UvUq5nV2hv)dEmpCE-9m>f|vqniM?*/pOJ}yK7I=^^xa"7@"(\w+ nearly half 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. RATINGS AND REVIEWS . Understanding how to enroll or anything else in between weve got you covered. Box 5907 Troy, MI 48007, Mailing Address for Customer Service, Claims, Appeals & Grievances: (California plans) P.O. Why Choose Essence Healthcare Medicare Advantage. She is also an accomplished entrepreneur, having co-founded a successful disease and complex case management firm. Now that I have better dental insurance i wish I would give them my services every again. When it comes to switching to an all-in-one Medicare Advantage plan from Original Medicare, theres a lot of new to consider. To what degree does Medicaid provide adult dental coverage? They really take care of me. where consumers can shop for dental coverage in the U.S. how much dental insurance might cost you and. 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. We width: 100%; We sent a one-time security code to {#maskedTwoFactorSMS}. Under pediatric dental coverage obtained via a health insurance marketplace, orthodontia will generally only be covered when considered medically necessary. A full breakdown of points can be seen It is evident that the individual should prioritize overall care to minimize the need for Tier 2 and Tier 3 level services. 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's Medicare plan previews for 2023 have been released. Before joining Essence, Richard served as chief financial officer of Essence Group Holdings Corporation (including Essence Healthcare), national president of United Healthcares Medicare and Medicaid lines of business, president and CEO of Coventry Healthcare of the Midwest, and chief financial officer of Coventry Corporation. 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). To enroll in an Essence Healthcare plan, you must have both Medicare Parts A and B and reside in the plan service area. { Your child should visit the dentist every six months for regular dental cleanings and checkups. Outside of the office, Dr. Zimmerman enjoys traveling especially to visit her three children. He cracked 5000$ veneers in the process and abandoned my care. These limits will increase to $400 and $800, respectively, in 2024. She has extensive expertise in process improvement, health center administration facilities management, and information systems operations. She is also an accomplished entrepreneur, having co-founded a successful disease and complex case management firm.