1. Services provided by dental therapist. An insurer that issues group dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by a dental therapist licensed under Title 32, chapter 143 when those services are covered services under the contract and when they are within the lawful scope of practice of the dental therapist.

[PL 2019, c. 388, §4 (AMD).]

Terms Used In Maine Revised Statutes Title 24-A Sec. 2847-U

  • Contract: A legal written agreement that becomes binding when signed.
  • health insurance: means insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, including provision for the mental and emotional welfare of human beings by defraying the costs of legal services only to the extent provided for in chapter 38. See Maine Revised Statutes Title 24-A Sec. 704
2. Limits; coinsurance; deductibles. A contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.

[PL 2013, c. 575, §6 (NEW); PL 2013, c. 575, §10 (AFF).]

3. Coordination of benefits with dental insurance. If an enrollee eligible for coverage under this section is eligible for coverage under a dental insurance policy or contract and a health insurance policy or contract, the insurer providing dental insurance is the primary payer responsible for charges under subsection 1 and the insurer providing group health insurance is the secondary payer.

[PL 2013, c. 575, §6 (NEW); PL 2013, c. 575, §10 (AFF).]

SECTION HISTORY

PL 2013, c. 575, §6 (NEW). PL 2013, c. 575, §10 (AFF). PL 2015, c. 429, §14 (AMD). PL 2019, c. 388, §4 (AMD).