Common use of Alternate Benefits Clause in Contracts

Alternate Benefits. In all cases in which there is more than one Course of Treatment or service to treat a Participant’s dental condition, the benefit will be based on the least costly Course of Treatment or covered service, as determined by the Plan. When two or more services are submitted and the services are considered part of the same service, the Plan will pay the most comprehensive service as determined by the Plan. When two or more services are submitted on the same day and the services are considered mutually exclusive (one service contradicts the need for the other service), the Plan will pay for the service that represents the final treatment as determined by the Plan. If you and your Dentist decide on personalized restorations, or personalized complete or partial dentures and overdentures, or to employ specialized techniques for dental services rather than standard procedures, the benefits provided will be limited to the benefit for the least costly Course of Treatment procedures for dental services, as determined by the Plan.

Alternate Benefits. In all cases in which there is more than one Course of Treatment or service to treat a Participant’s dental condition, the benefit will be based on the least costly Course of Treatment or covered service, as determined by the Plan. When two or more services are submitted and the services are considered part of the same service, the Plan will pay the most comprehensive service as determined by the Plan. When two or more services are submitted on the same day and the services are considered mutually exclusive (one service contradicts the need for the other service), the Plan will pay for the service that represents the final treatment as determined by the Plan. If you You and your Your Dentist decide on personalized restorations, or personalized complete or partial dentures and overdentures, or to employ specialized techniques for dental services rather than standard procedures, the benefits provided will be limited to the benefit for the least costly Course of Treatment procedures for dental services, as determined by the Plan.