Questions & answers · Dental insurance
What events does Medico Insurance Company's filed dental insurance policy say it pays for?
AI-drafted from filed documents · reviewed: pendingwhether a specific event is coveredMedico Insurance Company
Medico Insurance Company's filed dental insurance policy in Alabama (AL) states it pays for diagnostic and preventive services, including periodic, comprehensive, limited, or problem-focused oral evaluations and reevaluations [1]. It pays coinsurance for a bacteriological culture test performed during the evaluation [1]. It pays coinsurance for a routine dental cleaning, including all scaling and polishing procedures [1]. It pays coinsurance for bitewing radiographs [1]. It pays coinsurance for amalgam or composite restorations (fillings) [1]. It pays coinsurance for an intraoral periapical or occlusal X-ray image, an extraoral X-ray image, a complete series of X-rays, or a panoramic X-ray image [1]. If a complete series or panoramic X-ray is performed in a calendar year, the complete series X-ray benefit or panoramic X-ray benefit replaces the Diagnostic and Preventive Services Bitewing X-rays benefit for that same calendar year [1]. It pays coinsurance for nonsurgical extractions consisting of coronal remnants of a deciduous tooth or erupted tooth or exposed root [1]. This benefit is limited to a maximum combined benefit of up to [four teeth] in conjunction with the Major Services Surgical Extractions – Erupted Tooth benefit [1]. This does not appear in these excerpts — check the full policy.
Information only — not legal advice. The insurer decides.
These answers quote forms insurers filed with state regulators. Your own policy, its endorsements and your state’s rules control. A filed form may not be the version sold to you.
Where this comes from (2)
[1] Medico Insurance Company · AL · SERFF MDIC-132797683 · form DEN2021(AL) · p. 8 · 8.1 · DENTAL BENEFITS
DENTAL BENEFITS Diagnostic and Preventive Services: Evaluations: We will pay our coinsurance amount for periodic, comprehensive, limited or problem focused oral evaluations and reevaluations. We will pay our coinsurance amount for a bacteriological culture test performed during the evaluation. Cleanings: We will pay our coinsurance amount for a routine dental cleaning, including all scaling and polishing procedures. Bitewing X-rays: We will pay our coinsurance amount for bitewing radiographs. Basic Services: Restorations (Fillings): We will pay our coinsurance amount for amalgam or composite restorations. X-rays: We will pay our coinsurance amount for an intraoral periapical or occlusal X-ray image, an extraoral X-ray image, a complete series of X-rays or a panoramic x-ray image. If a complete series or panoramic X-ray is performed in a calendar year, the complete series X-ray benefit or panoramic X-ray benefit replaces the Diagnostic and Preventive Services Bitewing X-rays benefit for that same calendar year. Nonsurgical Extractions: We will pay our coinsurance amount for nonsurgical extractions consisting of coronal remnants of a deciduous tooth or erupted tooth or exposed root. This benefit is limited to a maximum combined benefit of up to [four teeth] in conjunction with the Major Services Surgical Extractions – Erupted Tooth benefit. … (excerpt — the filed text continues)
[2] Medico Insurance Company · AL · SERFF MDIC-132797683 · p. 1 · 3 · BENEFIT
BENEFIT Calendar Year Maximum Carry-over Benefit: A covered person may carry-over any unused portion of the calendar year maximum benefit amount to the next calendar year. The combined total of the calendar year maximum carry- over benefit and the current year’s calendar year maximum benefit amount may not exceed [$3,000]. PREMIUM We can change the premium for this rider if we change the premium for all riders similar to yours which are issued to persons of your class. If it is necessary to change the premium for this rider, we will send you written notice in advance of the change in premium.
Drafted by a local AI model from the excerpts above, then checked by rules (citations, no rankings, no “not covered” claims from a partial excerpt). Question id Q620b6de3. Spotted an error? Tell us.