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Another Teamcare concession
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<blockquote data-quote="Mugarolla" data-source="post: 1415172" data-attributes="member: 8481"><p>Don't know what plan you were in. I see the exclusion for dental implants in your summary unless medically necessary. Here are the exclusions in the plan that I was in. Nothing about dental implants. Trust me, implants were covered in my old plan. They are not in Teamcare.</p><p></p><p><em>What is Not Covered Under</em></p><p><em></em></p><p><em>Dental Options 1 and 2</em></p><p><em></em></p><p>In addition to services not specifically</p><p></p><p>listed in <em>Covered Expenses </em>above, the</p><p></p><p></p><p>following expenses are not covered</p><p></p><p>by the dental options:</p><p></p><p>• Remineralization (Calcium Hydroxide,</p><p></p><p>temporary restoration) as a separate procedure</p><p></p><p>only</p><p></p><p>• Occlusal adjustment (unless following</p><p></p><p>periodontal surgery) or retainers if charged</p><p></p><p>separately from orthodontic treatment</p><p></p><p>• Claims received more than 12 months</p><p></p><p>past the date of service</p><p></p><p>• IV sedation, except in certain circumstances;</p><p></p><p>call Aetna at 1-800-UPS-1508</p><p></p><p>• Appliances, restoration or procedures</p><p></p><p>needed to alter vertical dimensions or</p><p></p><p>restore occlusion or for the purpose of</p><p></p><p>splinting or correcting non-severe attrition</p><p></p><p>or abrasion</p><p></p><p>• Dentures and bridgework when they are</p><p></p><p>for the replacement of teeth that were</p><p></p><p>extracted before the patient was covered</p><p></p><p>by a UPS-administered dental plan</p><p></p><p>• Orthodontic treatment begun before covered</p><p></p><p>by a UPS-administered dental plan</p><p></p><p>• Root canal therapy, if the pulp chamber</p><p></p><p>was opened before the patient was covered</p><p></p><p>by a UPS dental option</p><p></p><p>• Relines and adjustments of dentures and</p><p></p><p>partial dentures within six months after</p><p></p><p>installation</p><p></p><p>• Cosmetic dental services and supplies,</p><p></p><p>including personalization or characterization</p><p></p><p>of dentures</p><p></p><p>• Prosthetic devices and appliances, including</p><p></p><p>bridges and crowns, and expenses</p><p></p><p>for fitting or modifying them, if installed</p><p></p><p>or delivered more than 30 days after the</p><p></p><p>patient’s coverage ends</p><p></p><p>• Replacement of lost, stolen or broken</p><p></p><p>appliances</p><p></p><p>• Replacement of congenitally missing teeth</p><p></p><p>• Education programs, such as plaque control</p><p></p><p>or oral hygiene instruction</p><p></p><p>• A charge for a replacement or modifi -</p><p></p><p>cation of a partial or fully removable</p><p></p><p>denture, a removable bridge or fi xed</p><p></p><p>bridgework, or for adding teeth to any</p><p></p><p>of these, or for a replacement or modifi -</p><p></p><p>cation of an inlay, onlay, crown or cast</p><p></p><p>processed restoration, within fi ve years</p><p></p><p>after installation</p><p></p><p>• Localized delivery of antimicrobial</p><p></p><p>agents; such as Actisite®, Atridox®,</p><p></p><p>Arestin® and PerioChip®</p><p></p><p>• Local anesthesia or nitrous oxide,</p><p></p><p>as a separate charge</p><p></p><p>• Any prescription drug</p><p></p><p>• Full mouth debridement</p><p></p><p>• Guided tissue regeneration</p><p></p><p>• Desensitization treatment</p><p></p><p>• Precision attachments except as noted</p><p></p><p>under <em>Major Services </em>in this section</p><p></p><p></p><p>• Infection control</p><p></p><p>• Behavior management</p><p></p><p>• Canal preparation, if submitted as</p><p></p><p>a separate charge</p><p></p><p>• Rubber dam</p><p></p><p>• Services not required for the treatment of</p><p></p><p>a specific condition or to maintain good</p><p></p><p>dental hygiene, as determined by Aetna</p><p></p><p>• Services not reasonably necessary or</p><p></p><p>customarily performed, as determined in</p><p></p><p>keeping with guidelines adopted by Aetna</p><p></p><p>• Services not furnished by a licensed</p><p></p><p>dentist, except services provided by a</p><p></p><p>licensed hygienist under the direction of</p><p></p><p>a dentist or X-rays ordered by a dentist</p><p></p><p>• Services covered by the medical options</p><p></p><p>• Charges for a missed or broken</p><p></p><p>appointment</p><p></p><p>• Charges for the dentist’s travel</p></blockquote><p></p>
[QUOTE="Mugarolla, post: 1415172, member: 8481"] Don't know what plan you were in. I see the exclusion for dental implants in your summary unless medically necessary. Here are the exclusions in the plan that I was in. Nothing about dental implants. Trust me, implants were covered in my old plan. They are not in Teamcare. [I]What is Not Covered Under Dental Options 1 and 2 [/I] In addition to services not specifically listed in [I]Covered Expenses [/I]above, the following expenses are not covered by the dental options: • Remineralization (Calcium Hydroxide, temporary restoration) as a separate procedure only • Occlusal adjustment (unless following periodontal surgery) or retainers if charged separately from orthodontic treatment • Claims received more than 12 months past the date of service • IV sedation, except in certain circumstances; call Aetna at 1-800-UPS-1508 • Appliances, restoration or procedures needed to alter vertical dimensions or restore occlusion or for the purpose of splinting or correcting non-severe attrition or abrasion • Dentures and bridgework when they are for the replacement of teeth that were extracted before the patient was covered by a UPS-administered dental plan • Orthodontic treatment begun before covered by a UPS-administered dental plan • Root canal therapy, if the pulp chamber was opened before the patient was covered by a UPS dental option • Relines and adjustments of dentures and partial dentures within six months after installation • Cosmetic dental services and supplies, including personalization or characterization of dentures • Prosthetic devices and appliances, including bridges and crowns, and expenses for fitting or modifying them, if installed or delivered more than 30 days after the patient’s coverage ends • Replacement of lost, stolen or broken appliances • Replacement of congenitally missing teeth • Education programs, such as plaque control or oral hygiene instruction • A charge for a replacement or modifi - cation of a partial or fully removable denture, a removable bridge or fi xed bridgework, or for adding teeth to any of these, or for a replacement or modifi - cation of an inlay, onlay, crown or cast processed restoration, within fi ve years after installation • Localized delivery of antimicrobial agents; such as Actisite®, Atridox®, Arestin® and PerioChip® • Local anesthesia or nitrous oxide, as a separate charge • Any prescription drug • Full mouth debridement • Guided tissue regeneration • Desensitization treatment • Precision attachments except as noted under [I]Major Services [/I]in this section • Infection control • Behavior management • Canal preparation, if submitted as a separate charge • Rubber dam • Services not required for the treatment of a specific condition or to maintain good dental hygiene, as determined by Aetna • Services not reasonably necessary or customarily performed, as determined in keeping with guidelines adopted by Aetna • Services not furnished by a licensed dentist, except services provided by a licensed hygienist under the direction of a dentist or X-rays ordered by a dentist • Services covered by the medical options • Charges for a missed or broken appointment • Charges for the dentist’s travel [/QUOTE]
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