MMC Benefits Handbook
Orthognathic Coverage
NOTE: Out-of-network services are not covered under the Anthem BCBS Narrow Network (National Blue High Performance Network (Blue HPN)) except for urgent and emergency care. There are some providers in New Jersey and Philadelphia that are listed as Tier 2 on Anthem BCBS's provider search (National Blue High Performance Network (Blue HPN)) that can be used and are covered at the out-of-network benefit level. Providers not labeled as Tier 2 cannot be used for out of network coverage.
The Plan covers the diagnosis or treatment of the jawbones, including orthognathic surgery (procedure to correct underbite or overbite, and jaw alignment. Prior authorization is required. Contact the Claims Administrator for specific details.