Glossary of Terms
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Emergency Services
Specialist Services
Benefits, Limitations and Exclusions
Renewal, Cancellation and Termination of Benefits
Conversion
Entire Contract
Schedule A
Description of Benefits and Copayments

Schedule B
Limitations and Exclusions

 
 
 
 
 

SPECIALIST SERVICES

Specialist Services for oral surgery, endodontics, periodontics or pediatric dentistry, must be

  1. referred by the assigned Contract Dentist, and
  2. preauthorized by us. You pay the specified Copayment. See 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.
 
 
 
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