COVERED DENTAL CARE SERVICES means any dental service, treatment, or procedure that we have determined is eligible for reimbursement under this plan. PREDETERMINATION is a procedure whereby you or your dentist sends us your treatment plan before treatment is rendered and we review to determine if a proposed treatment is covered under your plan. A predetermination is an estimate, not a guarantee of payment, and is based on your eligibility status and benefits at the time of the request. It is subject to change. In addition, predetermination also determines if a dental service is dentally necessary, or is medically necessary for an orthodontics service.
Medical care means amounts paid for:
Emergency medical care means such medical procedures as:
Child care means continuous care and supervision of five or more qualifying children that is:
Foster care means substitute care furnished on a 24-hour-a-day basis to an eligible child in a licensed or approved facility by a person or agency other than the child’s parent or guardian but does not include care provided in a family home through an informal arrangement for a period of 20 days or less. Child foster care shall include but is not limited to the provision of food, lodging, training, education, supervision, and health care.