Orthodontic Treatment. 50% of the cost of treatment based on the ODA schedule in effect during the term of this agreement, for dependent children ages 6-21. Treatment required to correct malocclusion of teeth (maximum benefit is $1,000 per year for each covered dependent with a lifetime maximum of $2,000.00).
Orthodontic Treatment. (i) 50% of the cost of treatment based on the ODA schedule in effect during the term of this agreement, for dependent children ages 6–21.
Orthodontic Treatment. The Employer agrees to provide for services relating to orthodontics only to dependent unmarried children of the employee between the ages of six (6) and eighteen (18), on the basis of fifty percent/fifty percent (50%/50%) co-insurance, in accordance with the current Ontario Dental Association Schedule of Fees, up to a lifetime maximum benefit of two thousand, five-hundred dollars ($2,500.00) for each such dependent unmarried child. Note: Bands must be inserted before nineteenth (19th) birthday.
Orthodontic Treatment. This is any • Medical service or supply; or • Dental service or supply; furnished to prevent or to diagnose or to correct a misalignment: • Of the teeth; or • Of the bite; or • Of the jaws or jaw joint relationship; whether or not for the purpose of relieving pain. Not included is: • The installation of a space maintainer; or • Surgical procedure to correct malocclusion. Out-of-Network Service(s) and Supply(ies) Health care service or supply that is furnished by an out-of network provider Out-of-Network Provider A health care provider, pharmacy, or dental provider who has not contracted with Aetna to furnish services or supplies at a negotiated charge. Out-of-Pocket Limit The amount that must be paid by the covered student or the covered student before covered medical expenses will be payable at 100% for the remainder of the policy year. Partial Hospitalization Treatment This is a plan of medical, psychiatric, nursing, counseling, or therapeutic services to treat mental disorders and substance abuse. The plan must meet these tests: • It is carried out in a hospital; psychiatric hospital or residential treatment facility; on less than a full-time inpatient basis; • It is in accord with accepted medical practice for the condition of the person; • It does not require full-time confinement; and • It is supervised by a psychiatrist who weekly reviews and evaluates its effect. Pharmacy: This is an establishment where prescription drugs are legally dispensed. Physician: This is a duly licensed member of a medical profession who: • Has an M.D. or D.O. degree; • Is properly licensed or certified to provide medical care under the laws of the jurisdiction where the individual practices; and • Provides medical services which are within the scope of his or her license or certificate. This also includes a health professional who: • Is properly licensed or certified to provide medical care under the laws of the jurisdiction where he or she practices; • Provides medical services which are within the scope of his or her license or certificate; • Under applicable insurance law, is considered a "physician" for purposes of this coverage; • Has the medical training and clinical expertise suitable to treat the covered person’s condition; • Specializes in psychiatry, if your sickness or injury is caused, to any extent, by substance abuse or a mental disorder; • A physician is not the covered person or related to a covered person.
Orthodontic Treatment i. Correction of malocclusion of the teeth
Orthodontic Treatment. The objective of the SHB/FHB is to provide major orthodontic treatment for beneficiaries with severe crippling malocclusions. Please screen clients – do not complete full assessments (service code 01910) on clients whose malocclusions may not be considered severe. Payment for service code 01910 (consultation, treatment plan and full records) may not be processed for cases where the malocclusion is not considered severe. In borderline cases where the malocclusion may be considered less than severe crippling, please complete an examination and take 2 to 3 pictures (service code 01900). Submit the pictures with a letter requesting approval to proceed. The Saskatchewan Ministry of Health will assess the extent of the malocclusion and advise if full records should be submitted. Non surgical A maximum of 24 active treatments (monthly maintenance) will be considered. Surgical A maximum of 32 active treatments (monthly maintenance) will be considered. Preliminary/minor treatment Preliminary or minor treatment may be covered if such treatment will prevent a severe crippling malocclusion. Payment under this category will preclude any future payment for orthodontic treatment for the patient. These treatment plans should clearly indicate: • the fee of the partial treatment/appliance, and • the number of active months of treatment.
Orthodontic Treatment models for analysis (including panoramic X-rays), molds, mobile wired and fixed dentures. Orthodontic treatment is allowed only with the written consent of the Insurer and only for insured persons below the age of 19.
Orthodontic Treatment of the cost of treatment based on the schedule in effect during the term of this agreement, for dependent children ages APPENDIX
Orthodontic Treatment. Treatment required to correct malocclusions of the teeth (maximum benefit is per year for each covered dependent with a lifetime maximum of $2,000.00).
Orthodontic Treatment. The Plan pays for 50% of eligible expenses for reasonable and customary charges for treatment rendered by an Orthodontist for the correction of malocclusions of a dependent child who is at least 6 but not more than 21 years of age when treatment commences. Necessary orthodontic appliances are also covered. SPECIAL CONDITIONS
