Benefits indicate which services are covered
under a benefit plan, at what percentage, how long a waiting period you
may have, and any rules that apply. To view benefit information:
Benefit information is divided into several sections. At the top of
the benefit information are any client-specific messages followed by:
Below this is information on benefit levels,
waiting periods, and rules, followed by maximums and deductibles, ortho
age limits, and COB information, if the benefit program includes those.
For easy reference, benefit levels, waiting periods, and rules are assigned
to several standard categories. These categories in turn contain subcategories,
and within these, individual procedures or services.
Benefits may also vary by provider network.
If so, the information is displayed for each network.
list routine procedures, dates of services provided, and whether they
are covered for the participating and non participating networks.
You can also use the Code Search feature
to find benefit information for a specific procedure code or service.
Enter the procedure code and click the Find
button to jump to benefit information for that code.
For each procedure category and/or code:
The maximums and deductibles section shows dollar amounts and other
information for maximums and deductibles.
The age limits for orthodontic treatment, if applicable. If the benefit
plan does not cover orthodontics, this section does not appear.
eligibility for dependents