Prosthodontics. We Cover prosthodontic services as follows: • Removable complete or partial dentures, for Members 15 years of age and above, including six (6) months follow-up care; • Additional services including insertion of identification slips, repairs, relines and rebases and treatment of cleft palate; and • Interim prosthesis for Members five (5) to 15 years of age. We do not Cover implants or implant related services. Fixed bridges are not Covered unless they are required: • For replacement of a single upper anterior (central/lateral incisor or cuspid) in a patient with an otherwise full complement of natural, functional and/or restored teeth; • For cleft palate stabilization; or • Due to the presence of any neurologic or physiologic condition that would preclude the placement of a removable prosthesis, as demonstrated by medical documentation.
Prosthodontics procedures for construction of fixed bridges, partial or complete dentures and the repair of fixed bridges; implant surgical placement and removal; and for implant supported prosthetics, including implant repair and recementation.
Prosthodontics. Insurance will pay ninety percent (90%) of the Usual and Customary charges, with the employee paying the balance.
Prosthodontics. Insurance will pay one hundred percent (100%) of the Usual and Customary charges, with the employee paying the balance.
Prosthodontics a. An upper or lower denture is a payable benefit once per arch in a sixty (60) consecutive month period.
Prosthodontics. Reimbursement for any type of prosthesis (removable or fixed) includes follow-up examinations and adjustments for the three-month period following the date on which the prosthesis is fitted. For the laboratory expenses included in a procedure, the eligible maximum is 50% of the dental surgeon’s fee for the dental procedure code at issue and in accordance with the maximum set forth in the Fee Guide. Unless otherwise specified, any type of prosthesis is reimbursed only once per five-year period.
Prosthodontics. Fixed bridges and partial or complete dentures are covered services for members under the age of 19. Replacements will be covered only if the existing fixed bridge, partial denture or complete denture meets the following criteria: it is more than five (5) years old, it is not serviceable, and it cannot be repaired. This agreement covers crowns over implants as a prosthodontic service for members under the age of 19. This agreement covers a single tooth implant as a prosthodontic service for members under the age of 19.
Prosthodontics. We Cover prosthodontic services as follows: • Removable complete or partial dentures, including six (6) months follow-up care; and • Additional services including insertion of identification slips, repairs, relines and rebases and treatment of cleft palate. We do not Cover implants or implant related services. Fixed bridges are not Covered unless they are required: • For replacement of a single upper anterior (central/lateral incisor or cuspid) in a patient with an otherwise full complement of natural, functional and/or restored teeth; • For cleft palate stabilization; or • Due to the presence of any neurologic or physiologic condition that would preclude the placement of a removable prosthesis, as demonstrated by medical documentation.
Prosthodontics. Fixed partial dentures (abutment crowns and pontics); removable complete and partial dentures, and pin retention.
Prosthodontics. The following prosthetic services are provided under Dental Amendatory Rider B: Dentures, full and partial Bridges, fixed and removable Addition of teeth to partial dentures to replace extracted teeth The dental services listed above are subject to the following qualifications: Anthem Blue Cross and Blue Shield will pay for standard procedures for prosthetic services as determined by us. For fixed bridges, we will pay for the replacement of missing teeth and for one tooth on either side or two teeth on one side of the replacement. We will not pay for a denture or bridge replacement which is provided less than five years following a placement or replacement which was covered under the contract. We also will not pay for crowns splinted together for any reason.
