CommercialCoverageMedium impact
Update: TWU Preferred Premier Dental Plan Notice
EmblemHealth·NY · Dentistry, Oral & Maxillofacial Surgery·Provider News
Effective date
Oct 15, 2024
We identified it
Jun 20, 2026
Summary
EmblemHealth clarified their dental implant coverage for TWU Local 100 members: covers one implant per 12 months with no annual maximum for in-network services, but out-of-network implant services have a $1,000 annual maximum. In-network implant services and related procedures are paid in full at contracted rates.
Action Required
Immediately: Billing team must verify TWU Local 100 member eligibility in EmblemHealth system before scheduling implant procedures. Update patient financial counseling scripts to explain in-network vs out-of-network implant coverage differences (no maximum vs $1,000 maximum). Ensure billing staff understand implant services are limited to one tooth per 12-month period.