Prosthodontics. We Cover prosthodontic services as follows: • Removable complete or partial dentures, including six (6) months follow-up care; 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.
Appears in 2 contracts
Samples: Preferred Provider Organization Contract, Preferred Provider
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.
Appears in 2 contracts
Samples: Preferred Provider, Preferred Provider
Prosthodontics. We Cover prosthodontic services as follows: • Removable complete or partial dentures, including six (6) months follow-up care; Additional services including insertion of identification slips, repairs, relines and rebases and treatment of cleft palate. ; and 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.
Appears in 1 contract
