Orthodontia. We will pay for procedures which help to restore oral structures to health and function and to treat serious medical conditions such as cleft palate and cleft lip; maxillary/ mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankyloses of the temporomandibular joint; and other significant skeletal dysplasias. Prior approval is required. Fidelis Care uses a company called DentaQuest to manage your dental benefit. You must use a DentaQuest dentist for your dental care. If you have questions related to your dental care, or need to find a dental provider, please call the Fidelis Care Member Services Department at 1- 888-FIDELIS (0-000-000-0000).
Appears in 4 contracts
Samples: Health Plus Subscriber Contract, Health Plus Subscriber Contract, Health Plus Subscriber Contract
