Covered Services

These are the dental services and procedures your plan covers. Not all care is covered. Even if a service is covered, you may still need to pay a deductible or co-insurance. Policies should contain a detailed list of what is and is not covered. If a procedure or service is not covered, your plan will not pay for it and you will be billed by your provider.

  • Be sure to check the "Exclusions and Limitations" section of your policy to ensure your treatment is covered. Restrictive conditions stated in a dental benefit contract may include age, length of time covered and waiting periods. Your plan may also exclude certain benefits or services as well as limit the extent or conditions under which certain services are provided.
  • Additionally, it is important to review the frequencies that each service is covered. For example, you may want to check to see if your plan covers one or two cleanings per calendar year.
  • If your dentist is proposing extensive treatment, encourage them to submit a treatment plan to your insurer's claims department to get a good idea of what will be covered.