When is it necessary to get advance approval (predetermination of benefits) under the Dental Expense Plan?
You must request a predetermination of benefits for services that include crowns, inlays, onlays, periodontics, prosthodontics (removable or fixed), or orthodontics regardless of the cost. Without advanced approval, these services will not be reimbursed. Also, it is strongly recommended that you ask your dentist to file a predetermination of benefits for any dental expenses over $300.00. Predetermination allows you to know what services are covered and what payments will be made before dental work is done.
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