Urgent Dental Care definition

Urgent Dental Care means care required to prevent serious deterioration in a Member’s health, following the onset of an unforeseen condition. Urgent care is care required within 24 to 72 hours, and includes only services needed to prevent the serious deterioration of your dental health resulting from an unforeseen illness or injury for which treatment cannot be delayed.

Urgent Dental Care means where malignancy is suspected or there is acute and intractable pain, sepsis or trauma.

Urgent Dental Care means the management of conditions that require prompt attention to relieve pain and/or risk of infection and to alleviate the burden on hospital emergency departments. These should be treated as minimally invasively as possible. Urgent dental care is distinguished from emergency dental care in that, urgent dental care requires prompt but not immediate treatment. Examples include dull toothache, mildly swollen gums, or small chips or cracks in teeth. Members shall be seen or treated for Urgent Dental care within two weeks. Urgent care treatment is limited to covered services.

Examples of Urgent Dental Care in a sentence

• Elective care and care for conditions that could have been reasonably foreseen are not covered under your Emergency Dental Care or Urgent Dental Care benefits.

• We cover Urgent Dental Care received in our Service Area from Participating Providers and Participating Dental Offices only if the Services would have been covered under other headings of this “Benefits” section (subject to the “Exclusions and Limitations” section) if they were not urgent.

• We do not cover Urgent Dental Care (or other Services that are not Emergency Dental Care) received outside of our Service Area or received from Non-Participating Providers and Non-Participating Dental Offices.

• Under certain emergency situations as explained under the section titled Emergency and Urgent Dental Care, services by a non-contracted general dentist may be covered.

• You pay the amount shown in the “Benefit Summary.” Your Participating Provider may require an additional fee added to any other applicable Copayments or Coinsurance when you receive Emergency Dental Care or an Urgent Dental Care appointment from a Participating Provider by the next business day after you contact us.

• You pay the amount shown in the “Benefit Summary.” An Emergency Dental Care office visit Copayment may apply when you receive Emergency Dental Care or an Urgent Dental Care appointment from a Participating Provider.

• Exclusions Additional fees a Non-Participating Provider may charge for an Emergency Dental Care or Urgent Dental Care visit after our payment for covered Services.

• You pay the amount shown in the “Benefit Summary.” There may be an additional fee added to any other applicable Copayments or Coinsurance when you receive Emergency Dental Care or an Urgent Dental Care appointment from a Participating Provider by the next business day after you contact us.

• Fees a provider may charge for an Emergency Dental Care or Urgent Dental Care visit.

• You pay the amount shown in the “Benefit Summary.” An Emergency Dental Care office visit Copayment may apply in addition to any other applicable Cost Share when you receive Emergency Dental Care or an Urgent Dental Care appointment from a Participating Provider.

More Definitions of Urgent Dental Care

Urgent Dental Care means the management of dental conditions that require immediate attention to relieve severe pain and/or risk of infection in order to avoid the likely onset of an emergency dental condition.