Medical Care Related to Outpatient or Inpatient Dental Services
Facility charges and associated medical care expenses incurred in connection with dental care provided in a medical care facility are covered only if:
- A physician, not a dentist, certifies that dental treatment in an outpatient or inpatient medical care facility is necessary to safeguard the life or health of the patient.
- Participants cannot be enrolled in any other plan or program that provides any coverage for facility charges or associated medical expenses incurred in connection with dental care provided in a medical care facility.
Only the medical care facility charge and charges for associated medical services are covered. The dental procedure(s) itself is not covered under CarePlus.
Participants must obtain prior approval. If prior approval is not obtained, no benefits will be payable under the program.
Coverage is at 80 percent of the allowed charge.