You should discuss any proposed basic or major restorative treatments with your dentist to understand both the cost of the treatment and to determine if a proposed treatment plan (dental predetermination) is needed. To avoid surprise out-of-pocket expenses, we recommend having your dentist submit a dental predetermination in advance of any proposed treatment, especially if the cost is $800 or more.
On occasion, ASEBP may request pre-treatment X-rays or other information from your dentist to support a treatment plan. Where two or more courses of treatment are submitted, reimbursement will be based on the least expensive of the proposed treatments.
Here are some important things for you to know: