Adult Benefits dental services under this Contract for people age 19 years and older.
Adult Benefits. The Benefits under this Section apply to Members age 21 and older. After any applicable Waiting Period, and after the Member’s payment of the corresponding deductible and coinsurance, according to the Schedule of Dental Benefits, this Contract will cover the Benefits as described in this Section. Benefits will be covered up to the Annual Maximum Benefit per Member stated in the Schedule of Dental Benefits.
Adult Benefits. Please refer to the Schedule of Benefits for Cost-Sharing requirements, day or visit limits, and any Preauthorization or Referral requirements that apply to these benefits. Adult Dental Care: We Cover the following dental care services for members age 19 and over:
Adult Benefits. The Benefits under this Section apply to Members age 21 and older. After any applicable Waiting Period, and after the Member’s payment of the corresponding deductible and coinsurance, according to the Schedule of Dental Benefits, this Contract will cover the Benefits as described in this Section. Benefits will be covered up to the Annual Maximum Benefit per Member stated in the Schedule of Dental Benefits. Diagnostic and Preventive Services Oral Exams Two periodic or comprehensive oral exams every 12 months. Once a comprehensive evaluation is paid, the Member is not eligible to undergo the same service with the same Provider, unless there is a significant change in health condition or the Member is absent from the Provider for 3 or more years. One limited problem-focused oral exam and consultations per Provider per patient per 12 months. Oral Cleanings (Prophylaxis) Limited to two every 12 months. One additional cleaning during the Policy Year will be allowed for Members that are under the care of a medical professional during pregnancy.
