Orthodontics Pre Sample Clauses

The "Orthodontics Pre" clause establishes the terms and conditions that apply to orthodontic treatments before a specified event or coverage period, such as the start of an insurance policy. Typically, this clause outlines whether orthodontic work that began prior to the policy's effective date is eligible for coverage, often excluding such pre-existing treatments from benefits. Its core function is to clarify the insurer's responsibility regarding ongoing orthodontic care, thereby preventing disputes and ensuring that only new treatments initiated during the coverage period are considered for reimbursement.
Orthodontics Pre determination is recommended for this service. See Section 8.0 -definition of pre- determination. Medically necessary orthodontics and related services are covered for members under the age of 19.