maxillofacial prosthetics e. provisional and/or temporary restorations (except an interim removable partial denture to replace extracted anterior permanent teeth during the healing period for children 16 years of age or under). Provisional and/or temporary restorations are not separately payable procedures and are included in the fee for completed service.
maxillofacial prosthetics. 6. Elective procedures (for example but not limited to, the prophylactic extraction of third molars).
maxillofacial prosthetics. Artificial devices that replace missing body parts of the head and neck region due to cancer, surgery, trauma, or birth defects. Member – A Subscriber or an enrolled Dependent. Occlusal Guard – A horseshoe shaped piece of plastic which is worn over the teeth to protect them against damage caused by clenching or grinding. It works by creating a physical barrier between the patient’s upper and lower teeth so that he/she bites against the plastic rather than wearing down his/her teeth. Onlay – A custom-made solid substance that works like an Inlay but covers one or more cusps or the entire biting surface of the tooth. It is usually used when the tooth is too damaged to support an Inlay, but not damaged enough to require a Crown. Orthodontics – A dental specialty that treats misalignment of teeth. Open Enrollment Period – A period of time each year designated by the Group or by federal government, during which a Subscriber and his eligible Dependents may enroll for coverage under this Benefit Plan. For enrollment through the SHOP, the Open Enrollment Period shall be thirty (30) days or longer, as required by federal law.
maxillofacial prosthetics. Artificial devices that replace missing body parts of the head and neck region due to cancer, surgery, trauma, or birth defects. Member – A Subscriber or an enrolled Dependent. Occlusal Guard – A horseshoe shaped piece of plastic which is worn over the teeth to protect them against damage caused by clenching or grinding. It works by creating a physical barrier between the patient’s upper and lower teeth so that he/she bites against the plastic rather than wearing down his/her teeth. Onlay – A custom-made solid substance that works like an Inlay but covers one or more cusps or the entire biting surface of the tooth. It is usually used when the tooth is too damaged to support an Inlay, but not damaged enough to require a Crown. Orthodontics – A dental specialty that treats misalignment of teeth. Open Enrollment Period – A period of time each year designated by the federal government, during which a Subscriber and his eligible Dependents may enroll for coverage under this Contract. The Open Enrollment Period shall be thirty (30) days or longer, as required by federal law. Over-Age Dependent – A Dependent Child (or Grandchild) who is age 26 or older, reliant on Subscriber for support, and is incapable of sustaining employment because of an intellectual or physical disability that began prior to age 26. Coverage of the Over-Age Dependent may continue after age 26 for the duration of incapacity if, prior to or within 31 days of the Dependent Child reaching age 26, an application for continued coverage with current medical information from the Dependent Child’s attending Physician is submitted to Company. Company may require additional or periodic medical documentation regarding the Dependent Child’s intellectual or physical disability as often as it deems necessary, but not more frequently than once per year after the two-year period following the child's 26th birthday. Company may terminate coverage of the Over-Age Dependent if Company determines the Dependent Child is no longer reliant on Subscriber for support or is no longer intellectually or physically disabled to the extent he is incapable of sustaining employment.
maxillofacial prosthetics. 29. Charges for case presentations for treatment planning or behavioral management.
maxillofacial prosthetics. For treatment of malignancies or neoplasms. For services and/or appliances that alter the vertical dimension (for example but not limited to, full- mouth rehabilitation, splinting, fillings) to restore tooth structure lost from attrition, erosion or abrasion, appliances or any other method. For replacement or repair of lost, stolen or damaged prosthetic or orthodontic appliances. For preventative restorations. For periodontal splinting of teeth by any method. For duplicate dentures, prosthetic devices or any other duplicative device. For which in the absence of insurance the Member would incur no charge. For plaque control programs, tobacco counseling, oral hygiene and dietary instructions. For any condition caused by or resulting from declared or undeclared war or act thereof, or resulting from service in the National Guard or in the Armed Forces of any country or international authority. For treatment and appliances for bruxism (night grinding of teeth). For any claims submitted to UCD by the Member or on behalf of the Member in excess of fifteen
maxillofacial prosthetics. 13. For treatment of malignancies or neoplasms.
maxillofacial prosthetics. 4) Provisional and/or temporary restorations (except an interim removable partial denture to replace extracted anterior permanent teeth during the healing period for children 16 years of age or under).
maxillofacial prosthetics. Artificial devices that replace missing body parts of the head and neck region due to cancer, surgery, trauma, or birth defects. Member – A Subscriber or an enrolled Dependent. Non-Participating Provider – A Provider that does not have a Provider Agreement with United Concordia Dental pertaining to payment for Covered Services rendered to a Member. Occlusal Guard – A horseshoe shaped piece of plastic which is worn over the teeth to protect them against damage caused by clenching or grinding. It works by creating a physical barrier between the patient’s upper and lower teeth so that he/she bites against the plastic rather than wearing down his/her teeth. Onlay – A custom-made solid substance that works like an Inlay but covers one or more cusps or the entire biting surface of the tooth. It is usually used when the tooth is too damaged to support an Inlay, but not damaged enough to require a Crown. Orthodontics – A dental specialty that treats misalignment of teeth. Open Enrollment Period – A period of time each year designated by the Group or by federal government, during which a Subscriber and his eligible Dependents may enroll for coverage under this Benefit Plan. For enrollment through the SHOP, the Open Enrollment Period shall be thirty (30) days or longer, as required by federal law.
maxillofacial prosthetics. For treatment of malignancies or neoplasms. For services and/or appliances that alter the vertical dimension (for example but not limited to, full-mouth rehabilitation, splinting, fillings) to restore tooth structure lost from attrition, erosion or abrasion, appliances or any other method. For replacement or repair of lost, stolen or damaged prosthetic or orthodontic appliances. For preventative restorations. For periodontal splinting of teeth by any method. For duplicate dentures, prosthetic devices or any other duplicative device. For which in the absence of insurance the Member would incur no charge. For plaque control programs, tobacco counseling, oral hygiene and dietary instructions. For any condition caused by or resulting from declared or undeclared war or act thereof, or resulting from service in the National Guard or in the Armed Forces of any country or international authority. For treatment and appliances for bruxism (night grinding of teeth). For any claims submitted to UCD by the Member or on behalf of the Member in excess of fifteen (15) months after the date of service. For incomplete treatment (for example but not limited to, patient does not return to complete treatment) and temporary services (for example but not limited to, temporary restorations). For procedures that are:
