The Affordable Care Act requires that non-grandfathered, insured health plans offered in the individual and small group markets, both inside and outside of the Exchanges, provide a core package of health care services, known as “essential health benefits” (EHB). Included in these core services is dental and vision care for children younger than age 19.
Children under the age of 19 who are members of VenturePlus plans or Signature Individual plans with an effective date of January 1, 2014 or later are covered.
The dental and vision services must be received from an approved Avesis network provider. In most cases, services received from an out-of-network provider (a provider who is not part of the Avesis network) will not be covered.
If your child is eligible to receive dental and vision care through their EHBs, you will find phone number for pediatric dental and vision service authorization on the BACK of your member ID card.:.
To find an approved Avesis provider of pediatric dental or vision benefits, search the Avesis online directory.
Search the Avesis Pediatric Dental and Vision Provider Directory
Call an Avesis customer service representative directly at 1-888-211-4030.
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