Orthodontics Sample Clauses
The Orthodontics clause defines the terms under which orthodontic treatments, such as braces or aligners, are covered or excluded by a dental or health insurance policy. It typically outlines the types of orthodontic services eligible for reimbursement, any age restrictions (such as coverage only for dependents under a certain age), and applicable limitations like waiting periods or maximum benefit amounts. This clause ensures clarity for both the insurer and the insured regarding the extent of orthodontic coverage, helping to prevent misunderstandings and manage expectations about out-of-pocket costs.
Orthodontics. We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias.
Orthodontics. The services of a certified Orthodontist registered as such by the College of Dental Surgeons of British Columbia only after the patient has been covered continuously for twelve (12) months. Appliances lost, broken or stolen will not be replaced. The maximum lifetime benefit is $3,500 per person for all services provided by an Orthodontist.
Orthodontics. Insurance will pay seventy five percent (75%) of the Usual and Customary charges, with the employee paying the balance. Maximum benefit payable for a combination of preventative, restorative, and prosthodontic care is two thousand dollars ($2,000) for each calendar year. Each calendar year, the employee may place the maximum benefit payable for preventative, restorative and prosthodontic care for each employee and dependent in a family bank. Maximum benefit payable for orthodontic care is three thousand five hundred dollars ($3,500) lifetime maximum, with fifty dollars ($50) deductible for employees and dependents. An employee’s eligible domestic partner and their children shall be entitled to the same coverage under this provision as spouses and dependent children of the employee, per Board Resolution 4455 and 4757.
Orthodontics. All dental services, including but not limited to ridge augmentation and vestibuloplasty, whether performed by Physicians, dentists, oral surgeons and/or any other provider, except for services provided as the result of a Dental Accident.
Orthodontics. Insurance will pay seventy-five percent (75%) of the Usual and Customary charges, with the employee paying the balance. Maximum benefit payable for a combination of preventative, restorative, and prosthodontic care is two thousand dollars ($2,000) for each calendar year. Each calendar year, the employee may place the maximum benefit payable for preventative, restorative and prosthodontic care for each employee and dependent in a family bank. Maximum benefit payable for orthodontic care is three thousand five hundred dollars ($3,500) lifetime maximum, with fifty dollars ($50) deductible for employees and dependents. Retirees shall have the option to purchase the same dental coverage as listed in this section at no cost to the District. Employees shall have the option to purchase, at their own expense, an enhanced dental plan. Benefits and premiums shall be established by the District annually, based on plan experience. Premiums for this benefit will be paid through payroll deduction.
Orthodontics. (1) If orthodontic treatment is terminated for any reason before completion, the obligation to pay benefits will cease with payment to the date of termination. If such services are resumed, benefits for the services, to the extent remaining, shall be resumed.
(2) The benefit payment for orthodontic services shall be only for months that coverage is in force.
Orthodontics. The services of a certified Orthodontist registered as such by the College of Dental Surgeons of British Columbia only after the patient has been covered continuously for twelve
Orthodontics. We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias. Procedures include but are not limited to: • Rapid Palatal Expansion (RPE); • Placement of component parts (e.g. brackets, bands); • Interceptive orthodontic treatment; • Comprehensive orthodontic treatment (during which orthodontic appliances are placed for active treatment and periodically adjusted); • Removable appliance therapy; and • Orthodontic retention (removal of appliances, construction and placement of retainers).
Orthodontics. Insurance will pay seventy-five percent (75%) of the Usual and Customary charges, with the employee paying the balance. Maximum benefit payable for a combination of preventative, restorative and prosthodontic care is two thousand dollars ($2,000) for each calendar year. Each calendar year, the employee may place the maximum benefit payable for preventative, restorative and prosthodontic care for each employee and dependent in a family bank. Maximum benefit payable for orthodontic care is three thousand five hundred dollars ($3,500) lifetime maximum with fifty dollars ($50) deductible for employees and dependents. Retirees shall have the option to purchase the same dental coverage as listed in this Section at no cost to the District.
Orthodontics. Costs paid by the plan shall be the following percentage calculated in accordance with the current fee schedule, or the dentists' usual and customary fee, whichever is the lesser.
1. Basic dental services - 80%.