Specialist Services for oral surgery, endodontics, periodontics or pediatric dentistry must be
- referred by the assigned Contract Dentist, and
- preauthorized by us. You pay the specified Copayment. (Refer to Schedule A.)
If the services of a Contract Orthodontist are needed, please refer to Section XI, Orthodontics, in Schedule A and Schedule B, Orthodontic Limitations and Exclusions to determine Benefits. |
