Expenses That Are Not Eligible
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.