Dentures. 1. Partial removable dentures, upper or lower, limited to one per 60 months
2. Complete removable dentures, upper or lower, limited to one per 60 months
3. Pre-operative radiographs required
4. Pre-treatment estimate, as described in the Estimate of Eligible Benefits section is recommended for Members
5. Tissue conditioning prior to denture impression
6. Repairs to denture as required including; repair resin denture base, repair cast framework, addition of tooth or clasp to existing partial denture, replacement of broken tooth, repairs or replacement of clasp, recement fixed partial denture
Dentures. 1. Partial removable dentures, upper or lower, limited to one per 60 months
2. Complete removable dentures, upper or lower, limited to one per 60 months
3. Pre-operative radiographs required
4. Pre-treatment estimate, as described in the Estimate of Eligible Benefits section is recommended for Members
5. Tissue conditioning prior to denture impression
6. Repairs to denture as required including; repair resin denture base, repair cast framework, addition of tooth or clasp to existing partial denture, replacement of broken tooth, repairs or replacement of clasp, recement fixed partial denture
D. Fixed prosthetics, including bridges and crowns, inlays and onlays used as abutments for or as a unit of the bridge limited to one per tooth per 60 months SAMPLE
E. Denture adjustments and relining limited to: Full or partial removable (upper or lower) dentures: once per 24 months, but not within six months of initial placement
F. Repair of prosthetic appliances, including fixed bridges, and removable dentures, full and/or partial. No limitations for Members under age 19. For Members over age 19, benefit limited to once in any twelve (12) month period per specific area of the appliance.
G. Repair of prosthetic appliances and removable dentures, full and/or partial.
X. Xxxxxxxx guard, by report, limited to one per 12 months for Members age 13 and older.
Dentures. 1. Partial removable dentures, upper or lower, limited to one (1) per sixty (60) months.
2. Complete removable dentures, upper or lower, limited to one (1) per sixty (60) months.
3. Pre-operative radiographs required.
4. Pre-treatment estimate, as described in Section 14.7F, Estimate of Eligible Benefits, is recommended.
5. Tissue conditioning prior to denture impression only.
6. Repairs to denture as required including: repair resin denture base, repair cast framework, addition of tooth or clasp to existing partial denture, replacement of broken tooth, repairs or replacement of clasp, recement fixed partial denture.
7. Adjust maxillofacial prosthetic appliance, by report, limited to one per six (6) months, per Member, per arch.
8. Maintenance and cleaning of a maxillofacial prosthesis (extra or intraoral) other than required adjustments, limited to one per six (6) months, per Member, per arch.
Dentures. 1. Partial removable dentures, upper or lower, limited to one per 60 months
2. Complete removable dentures, upper or lower, limited to one per 60 months
3. Pre-operative radiographs required
4. Pre-treatment estimate, as described in the Estimate of Eligible Benefits section is recommended for Members
5. Tissue conditioning prior to denture impression
6. Repairs to denture as required including; repair resin denture base, repair cast framework, addition of tooth or clasp to existing partial denture, replacement of broken tooth, repairs or replacement of clasp, recement fixed partial denture
D. Denture adjustments and relining limited to: Full or partial removable (upper or lower) dentures: once per 24 months, but not within six months of initial placement SAMPLE
E. Repair of prosthetic appliances and removable dentures, full and/or partial.
X. Xxxxxxxx guard, by report, limited to one per 12 months for Members age 13 and older
Dentures. Partial and complete dentures will be covered to a maximum of $1500.00. Insurance booklets and updates to the plan will be provided by the Hospital as changes occur. Insured persons age nineteen (19) or older will be eligible for reimbursement for dental recall examinations once every nine (9) months. Persons under age nineteen (19) will continue to be eligible once every six 6) months.
Dentures. To replace missing teeth with a removable prosthetic. One set of full upper and lower dentures (provided by either a dentist or denturist), and one set of partial dentures (provided only by a dentist), will be covered once every 60 months.
Dentures. 1. Partial removable dentures, upper or lower, limited to one per 60 months.
2. Complete removable dentures, upper or lower, limited to one per 60 months.
3. Pre-operative radiographs required.
4. Pre-treatment estimate, as described in Section 15.3F, Estimate of Eligible Benefits, is recommended.
5. Tissue conditioning prior to denture impression only.
6. Repairs to denture as required including: repair resin denture base, repair cast framework, addition of tooth or clasp to existing partial denture, replacement of broken tooth, repairs or replacement of clasp, recement fixed partial denture.
7. Adjustment to maxillofacial prosthetic appliance, by report, limited to one per 6 months, per Member.
8. Maintenance and cleaning of a maxillofacial prosthesis (extra or intraoral) other than required adjustments, limited to one per 6 months, per Member, per arch.
Dentures. At the time of admission it will be documented when a resident is admitted with dentures. Nursing will indicate if a resident wears dentures at all times or if there is a potential risk for loss. A care plan will be developed to address the risk for loss and the team will develop strategies to try to help prevent and minimize loss.
Dentures. For the denture coverage detailed below, the Plan reimburses eligible employees 50%, based on a one year lag of the Ontario Dental Association Fee Guide allowance for the eligible expense incurred by the employee and each eligible dependent to a calendar year maximum of $1,500 when combined with expenses for crowns and bridgework: - first installation, including adjustments, of partial permanent or full temporary or permanent removable dentures to replace 1 or more natural teeth; - denture adjustments that occur more than 3 months after installation; - replacement of an existing partial or full removable denture if it: - was installed at least 5 years before and cannot be made serviceable; or - is a temporary full denture which replaces 1 or more natural teeth and for which replacement by a permanent denture is required and takes place within 1 year from the date the temporary denture was installed; and - addition of teeth to an existing partial denture, if required to replace 1 or more natural teeth.
Dentures. Services required for the replacement of missing teeth through the use of removable dentures, including laboratory charges for materials. Coverage for both partial and full dentures is included once in any period of 3 years. Coverage is subject to limitations as defined below. Major restorative services required for the restoration of teeth, for the reconstruction of a tooth or for the replacement of missing teeth through the use of fixed bridges. It includes crowns, inlays, fixed bridges and cast restorations. Predetermination of Oral Care Benefits There will be times when you want to find out what payment you may expect to receive from the Insurance Carrier before you begin a plan of oral treatment. This process is called predetermination and we strongly urge you to use it whenever the anticipated cost of the oral treatment exceeds Simply have your dental practitioner write out a treatment plan for you and take this to your Plan Administrator for transmittal to the Insurance Carrier. We will send you a statement of the amount payable by the insurance plan. This will allow you to determine your own financial obligation prior to the commencement of treatment. Limitations No reimbursement will be made for expenses resulting from: -Services payable under any Workplace Safety and Insurance Act or any other statute; -Services payable under any government plan; -Self-inflicted injuries; -Service required as a result of war or hostilities of any kind; -Services required as a result of your participation in a criminal offence; -Services performed by a person who is ordinarily resident in the patient’s home; -Services for which reimbursement is payable due to the legal liability of any other party to the extent of such reimbursement; -Services other than those provided by a dental practitioner except those services which may be performed by legally qualified auxiliary personnel under the supervision of a dental practitioner, or those services which may be performed by a periodontal practitioner under the terms of the practitioner’s license; -Cosmetic services; -Crowns placed on a tooth not functionally impaired by or damage; -Dentures and bridgework (including crowns and inlays forming the abutments) to replace any teeth removed before the claimant became insured under this benefit or to replace a tooth or teeth congenitally missing; -Dentures which have been lost, stolen or mislaid; -Prosthetic devices which were ordered before the claimant became insured under t...
