The Dental Clinical Policies, Dental Coverage Guidelines and corresponding update bulletins for UnitedHealthcare Dental plans are listed below.
Expand All add_circle_outline Dental Policy Update Bulletins expand_moreA monthly notice of recently approved and/or revised Dental Clinical Policies and Coverage Guidelines is provided below for your review. We publish a new announcement on the first calendar day of every month.
The appearance of a dental service (e.g., procedure or technology) in the Dental Policy Update Bulletin does not imply that UnitedHealthcare provides coverage for the dental service. In the event of an inconsistency or conflict between the information provided in the Dental Policy Update Bulletin and the posted policy, the provisions of the posted policy will prevail.
Last Published 07.01.2024
This bulletin provides complete details on recently approved, revised, and/or retired UnitedHealthcare Dental Clinical Policies, Coverage Guidelines, and Utilization Review Guidelines.
Last Published 08.01.2024
This bulletin provides complete details on recently approved, revised, and/or retired UnitedHealthcare Dental Clinical Policies, Coverage Guidelines, and Utilization Review Guidelines.
Last Published 09.01.2024
This bulletin provides complete details on recently approved, revised, and/or retired UnitedHealthcare Dental Clinical Policies, Coverage Guidelines, and Utilization Review Guidelines.
Last Published 09.01.2024
A listing of the Dental Policy Update Bulletins for the past two rolling years.
UnitedHealthcare has developed Dental Clinical Policies and Dental Coverage Guidelines to assist us in administering dental plan benefits. These policies and guidelines are provided for informational purposes and do not constitute clinical advice. Treating dentists and other health care providers are solely responsible for determining what care to provide to their patients. Members should always consult their dentist or physician before making any decisions about dental or medical care.
Our Dental Clinical Policies express our determination of whether a dental service (e.g. procedure or technology) is proven to be effective based on the published clinical evidence. They are also used to decide whether a given dental service is clinically necessary. Services determined to be experimental, investigational, unproven, or not clinically necessary by the clinical evidence are typically not covered.
Dental Coverage Guidelines are used to determine whether a service falls within a benefit category or is excluded from coverage. Dental Coverage Guidelines may also address such matters as periodicity and other limitations, including whether a procedure is cosmetic, based on evidence.
Benefit coverage for dental services is determined by the member specific benefit plan document, such as a Certificate of Coverage, Schedule of Benefits, or Summary Plan Description, and applicable laws that may require coverage for a specific service. The member specific benefit plan document identifies which services are covered, which are excluded, and which are subject to limitations. In the event of a conflict, the member specific benefit plan document supersedes these policies and guidelines.
Dental Clinical Policies and Dental Coverage Guidelines are developed as needed, are regularly reviewed and updated, and are subject to change. They represent a portion of the resources used to support UnitedHealthcare coverage decision making. The information presented in these policies and guidelines is believed to be accurate and current as of the date of publication, and is provided on an "AS IS" basis. Additionally, UnitedHealthcare may use tools developed by third parties, including the American Dental Association and other peer organizations, to assist us in administering dental benefits. These third-party-guidelines are intended to be used in connection with the independent professional clinical judgment of a qualified dentist or other health care provider and do not constitute the practice of dentistry or dental advice.
Dental Clinical Policies and Dental Coverage Guidelines are the property of UnitedHealthcare. Unauthorized copying, use and distribution of this information are strictly prohibited. Third party guidelines are proprietary to the originating organization and are not published on this website.
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