In general, Original Medicare does not cover preventive dental healthcare services such as cleaning, routine dental exams, and dental X-rays. Routine dental care coverage is available to Blue Shield members enrolled in the following plans and counties. Please refer to your Evidence of Coverage (EOC) for a full list of covered dental procedures.
|Blue Shield Balance (HMO)
|Blue Shield Inspire (HMO)
|Blue Shield 65 Plus (HMO)||
|Blue Shield 65 Plus Plan 2 (HMO)
|Blue Shield TotalDual Plan (HMO D-SNP)||Los Angeles
|Blue Shield 65 Plus Choice Plan (HMO)
|Blue Shield AdvantageOptimum Plan (HMO)||Los Angeles
|Blue Shield AdvantageOptimum Plan 1 (HMO)
|Blue Shield Inspire (HMO D-SNP)||Fresno
|Blue Shield Select (PPO)||
|Blue Shield Enhanced (HMO)||
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.
- Routine eye exams, 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 costs.