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| EMERGENCY DENTAL SERVICES |
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| Your assigned Contract Dentist maintains a 24-hour Emergency Dental Services system seven days a week. The Contract Dentist will provide Emergency Dental Services for covered procedures whenever possible. If you require Emergency Dental Services and are unable to access care from your Contract Dentist, then we will reimburse you for the cost of such Emergency Dental Services which exceeds your Copayment. Emergency Dental Services will be limited to listed procedures, and as described in code D9110: Palliative (emergency) treatment of dental pain. Any further treatment of the cause of such Emergency Dental Services must be obtained from the Contract Dentist. (Refer to Schedule A.) You will be responsible for the Copayment(s). |
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