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.