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Voluntary termination of pregnancy (abortion).

This health plan covers chiropractic services furnished by a Chiropractor up to the dollar amount described in the benefit limit. These covered services include:

Voluntary termination of pregnancy (abortion).

Treatment to repair and/or replace sound, natural teeth damaged due to an accidental injury, but only when the care is furnished within 90 days of the accident. (For surgical benefits, refer to Surgery as an Outpatient.) No benefits are provided for dental care following an injury caused by biting or chewing.

Dental surgery for the repair or replacement of sound natural teeth damaged due to an accidental injury but only when the care is furnished within 90 days of the accident and when the accident occurs on or after the member's effective date. (No benefits are provided for dental services following an injury caused by biting or chewing.)

Endoscopic procedures that require anesthesia.

Orthodontic services furnished by a dentist for up to a lifetime benefit of $500 for each member for the treatment of a physical birth defect that is an approved prolonged illness condition.

Oral surgery. This includes: reduction of a dislocation or fracture of the jaw or facial bone; excision of a benign or malignant tumor of the jaw; removal of impacted wisdom teeth that are fully or partially imbedded in the bone; gingivectomies; alveolectomy or alveloloplasty; surgery of the oral cavity; and orthognathic surgery that is needed to correct a significant functional impairment that cannot be adequately corrected with orthodontic services.

This health plan covers routine physical exams furnished by a General Hospital, Community Health Center, Physician, Nurse Practitioner, Nurse Midwife or Independent Lab. These covered services include:

Blood cholesterol screening once every five years for a member age 6 or older.