Blue Cross Blue Shield FEP Dental
Section 3 How You Obtain Care
Section 3 How You Obtain Care
Alternate Benefit
If more than one service or procedure can be used to treat the dental condition, we reserve the right to authorize an alternate, less costly covered service as deemed by a dental professional to be appropriate and to meet broadly accepted national standards of dental practice.
If you and your dentist choose the more expensive treatment instead of the alternate benefit, you are responsible for the additional charges beyond the plan allowance for the alternate service.
Example: If a dental professional determines an implant is not dentally necessary or a less expensive appropriate treatment is available, no benefits will be allowed for the individual implant or implant related procedures, and the allowance for the less expensive treatment may be approved.
If you and your dentist choose the more expensive treatment instead of the alternate benefit, you are responsible for the additional charges beyond the plan allowance for the alternate service.
Example: If a dental professional determines an implant is not dentally necessary or a less expensive appropriate treatment is available, no benefits will be allowed for the individual implant or implant related procedures, and the allowance for the less expensive treatment may be approved.