DENTAL
Mercy Care Plan members under age 21 are covered for comprehensive dental services.
The use of preventive dental services is strongly encouraged. To support this, Mercy
Care Plan contracts directly with dental providers and allows members to select a
dentist from a published dental directory. No PCP referral or prior authorization
is required for a member to see a contracted general dentist.
Dental services for adults are limited to emergency dental services, medically necessary
dentures and pre-transplant dental services. Specific dental services covered under these
limitations can be determined by the member's dentist. No prior authorization is needed
for emergency services.
Mercy Care Advantage members are covered for additional limited services. Oral exams,
cleaning and fluoride treatments are covered services up to two visits a year. Dental
x-rays are covered once a year. No prior authorization is required.
Mercy Healthcare Group members are not covered for dental services.