In an Office. If you receive the dentally necessary services due to an accidental injury to your sound natural teeth in a doctor/dentist’s office, you are responsible for any applicable office visit copayment. See the Summary of Medical Benefits for details. Dentally necessary services are covered when received within seventy-two (72) hours of an accidental injury to your sound natural teeth. The following services are covered: • Extraction of teeth needed to avoid infection of teeth damaged in the injury; • Suturing; • Reimplanting and stabilization of dislodged teeth; • Repositioning and stabilization of partly dislodged teeth; and • Dental x-rays. Suture removal, performed where the original emergency dental services were received, is covered as part of our allowance for the original emergency treatment. We will ONLY cover a separate charge for suture removal if the suturing and suture removal are performed at different locations (i.e. sutures at emergency room and suture removal at doctor’s or dentist’s office).
In an Office. If you receive the medically necessary services due to an accidental injury to your sound natural teeth in a doctor/dentist’s office, you are responsible for any applicable office visit copayment. See the Summary of Medical Benefits for details. The amount that you pay for covered office visits differs depending on whether the service is the first, second or subsequent office visit in a calendar year. See the Summary of Benefits for benefit limits and your copayment amount. Medically necessary services are covered when received within seventy-two (72) hours of an accidental injury to your sound natural teeth. The following services are covered: • Extraction of teeth needed to avoid infection of teeth damaged in the injury; • Suturing; • Reimplanting and stabilization of dislodged teeth; • Repositioning and stabilization of partly dislodged teeth; and • Dental x-rays. Suture removal, performed where the original emergency dental services were received, is covered as part of our allowance for the original emergency treatment. We will ONLY cover a separate charge for suture removal if the suturing and suture removal are performed at different locations (i.e. sutures at emergency room and suture removal at doctor’s office).
