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Oral & Overall Health

Total Health Solutions Program
The Total Health Solution (THS) program provides education, targeted outreach, and condition-specific services to Enhanced Dental Benefit members who are pregnant, or have diabetes, coronary artery disease, or oral cancer. (Beginning September 1, 2019 on their account renewal, members who have been diagnosed with stroke or Sjogren’s syndrome will be included in the program.)

Enhanced Dental Benefits
Enhanced Dental Benefits offer full coverage for certain preventative and periodontal services connected to the total health of individuals with the conditions shown below. These benefits are paid at 100 percent and are not subject to deductibles, coinsurance, or calendar year maximums when performed by a participating or preferred dental provider.

Condition One cleaning or periodontal maintenance visit every 3 months Periodontal scaling once per quadrant every 24 months* Oral cancer screening once every 6 months Fluoride treatment every 3 months
Diabetes

 

 

Coronary artery disease

 

 

Pregnancy

 

 

Oral cancer

 

Stroke



 

 

Sjogren’s syndrome

 

* Available with plans that offer periodontal maintenance

Help your patients take advantage of Enhanced Dental Benefits
If you have a patient with one of the conditions above who is not yet enrolled, follow these steps to get them started:

Dentists: Primary care providers:
  1. Ask the patient to have their physician certify the diagnosis by submitting the Enhanced Dental Benefits Enrollment Form.
  2. Await your patient’s notification from us of their eligibility for the benefits.
  3. Provide enhanced dental benefits at no cost to the member.
  1. Certify your patient's diagnosis by submitting the Enhanced Dental Benefits Enrollment Form.
  2. Tell your patient that we will notify them of their eligibility for the benefits.
  3. Ask them to let their dentist know when they receive confirmation that they are enrolled in the program.
How to bill for Enhanced Dental Benefits
Submit your dental claim electronically or by mail in the same manner as all other dental claims.

Resources

To place an order
To have materials sent to your office, email DentalNetworkRequest@bcbsma.com and be sure to include:

  1. Name of piece/stock number (at bottom of document)
  2. Quantity
  3. Provider name and mailing address
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