(a) In this section, “covered service” means a dental care service for which reimbursement is available under an enrollee’s health care plan contract, or for which reimbursement is available subject to a contractual limitation, including:
(1) a deductible;
(2) a copayment;
(3) coinsurance;
(4) a waiting period;
(5) an annual or lifetime maximum limit;
(6) a frequency limitation; or
(7) an alternative benefit payment.
(b) A contract between a health maintenance organization and a dentist may not limit the fee the dentist may charge for a service that is not a covered service.

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Terms Used In Texas Insurance Code 843.3115

  • Contract: A legal written agreement that becomes binding when signed.