Dental Care

In general, preventative dental services such as cleaning, routine dental exams, and dental x-rays are not covered by Original Medicare.  Routine dental care coverage is available to Blue Shield members enrolled the following plans and counties.  Please refer to your Evidence of Coverage (EOC) for a full list of covered dental procedures. 

Plan Name County
Blue Shield Balance (HMO)
 
Los Angeles
Blue Shield Inspire (HMO)
Blue Shield 65 Plus Plan 2 (HMO)
Los Angeles
Orange
Blue Shield 65 Plus (HMO) 
Blue Shield TotalDual Plan (HMO D-SNP)
Los Angeles
Orange

San Bernardino
San Diego
Blue Shield 65 Plus Choice Plan (HMO) 
 
Riverside
San Bernardino
Blue Shield Vital (HMO) 
 
Los Angeles
Orange

Riverside
San Bernardino
Blue Shield AdvantageOptimum Plan (HMO) Fresno
Los Angeles
Merced
Orange
San Joaquin
Santa Clara
Stanislaus
Blue Shield AdvantageOptimum Plan 1 (HMO)
Blue Shield AdvantageOptimum Plan 2 (HMO)
San Diego
Blue Shield Coordinated Choice Plan (HMO) Fresno
Los Angeles
Merced 
Orange
San Bernardino
San Diego 
Santa Clara 
San Joaquin
Stanislaus
Blue Shield Inspire (HMO D-SNP) Fresno 
Merced
San Joaquin 
Stanislaus

 

Vision Care

Eye exams can often detect serious chronic conditions such as diabetes, hypertension, and high cholesterol. Luckily, whether you need treatment or just want preventive care we have you covered. 

Medicare covered services include Outpatient physician service for diagnosis and treatment of diseases and injuries of the eye, including treatment for age-related macular degeneration.  Refer to your Evidence of Coverage (EOC) for a full list of covered services. 
We also provide non-Medicare covered vision care obtained from a network provider.1 Covered services include:2
  • Routine eye exam, including refraction and prescription for eyeglass lenses. If the provider recommends additional procedures, you are responsible for paying the additional costs. Contact lens exam services and materials require additional fees. You are responsible for paying the additional cost.
  • Eyeglass frames and eyeglass lenses (including single, lined bifocal, lined trifocal, and lenticular lenses) or contact lenses. 

1 Prior authorization (approval in advance) is not required. Go to blueshieldca.com/find-a-doctor to locate a provider participating in the Vision Service Plan (VSP) network. 

2 Refer to your Evidence of Coverage for a full list of covered services and cost.