Dental - What's Not Covered
Delta Dental does not cover the following services, treatment and/or fees:
- cosmetic surgery or procedures for purely cosmetic reasons
- services for congenital or developmental malformations
- treatment to restore tooth structure lost from wear
- treatment to rebuild or maintain chewing surfaces due to teeth out of alignment or occlusion
- treatment to stabilize teeth (equilibration, periodontal splitting)
- services for any disturbance of the temporomandibular joints (jaw joints) or myofacial pain dysfunction
- services rendered by a dentist beyond the scope of his license
- services performed by any person other than a dentist or auxiliary personnel legally authorized to perform services under the supervision of a dentist
- charges by any hospital or other surgical or treatment facility and any additional fees charged by the dentist for treatment in any such facility
- oral hygiene instruction or dietary instructions
- prescribed drugs or other medication
- experimental procedures
- oral graft or conscious sedation
- gold foil restorations (treated as an optional service)
- implants or surgical removal of implants
- charges for general anesthesia, other than by a dentist properly licensed to administer general anesthesia in connection with covered oral surgery services
- dental services for which the eligible person incurs no charge
- dental services with charges that exceed what would have been made and actually collected if no coverage existed hereunder
- a posterior bridge where a partial denture in the same arch is not a covered benefit
- temporary partial dentures are a benefit only when anterior teeth are missing
- porcelain, gold or veneer crowns for children under 12
- fixed bridges or cast partials for children under 16
- services for injuries or conditions that are covered under Worker’s Compensation or Employer’s Liability Laws
- services provided by any federal, state or local agency, unless this exclusion is prohibited by law