Amalgam restorations: covered at 80% after deductible for basic restor…
Major restorative services including crowns may be covered at 50% afte…
Dental sealants: covered at 100% for patients age 15 and under, perman…
Resin-based composites (posterior): covered at 80% after deductible as…
Amalgam restorations: covered at 80% after deductible. Frequency limit…
Basic dental services are generally covered subject to plan provisions…
Preventive services: covered at 100% with no deductible. Adult prophyl…
Diagnostic X-rays: covered at 100% preventive benefit. Bitewing radiog…
Endodontic services: covered at 50% after deductible as major restorat…
Periodontal treatment: covered at 80% after deductible as basic period…
Implants: not a covered benefit under this plan. Members seeking impla…
Major prosthodontic services: covered at 50% after deductible. Waiting…
Basic restorative: covered at 80% after deductible. Anterior composite…
Diagnostic services: covered at 100% preventive benefit, no deductible…
Preventive services: fluoride treatment covered at 100%, no deductible…
Core buildups (D2950): covered at 50% as major restorative when submit…
Emergency dental treatment: D9110 covered at 100% preventive benefit w…
Orthodontic treatment: lifetime maximum $1,500 for eligible dependents…
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The system searches the verified case library first. Novel cases are synthesized by GPT-4o and routed for human review.