What Is Not Covered

The Dental Plan does not cover certain expenses, including (but not limited to) the following:

  • Care received before coverage was in effect
  • Cosmetic dental care
  • Gold caps
  • Instructions for keeping teeth clean
  • Care for which there is no charge
  • Dental care to treat diseases contracted, or injuries sustained, as a result of voluntary participation in a war (declared or undeclared), act of war, riot, or civil disobedience
  • Any alternative course of treatment that is more expensive than one consistent with accepted professional standards
  • Dental services for treatment of accidental injury (which are covered by the Medical Plan)
  • Expenses that would have been paid by a plan that was available from the spouse’s employer, regardless of whether the plan was elected by the spouse
  • Any expense listed in "Expenses That Are Not Eligible" in the Medical Plan section, except for those specifically covered by the Dental Plan
  • Care performed by:

    • A dentist who is not licensed to perform the services
    • A dentist who is paid by a hospital to treat patients or who is employed to treat employees or members of a mutual benefit association, labor union, or similar group
    • More than one dentist if you transfer from one dentist to another during the course of treatment (unless approved in advance by the Plan Administrator)
    • More than one dentist for a single procedure.