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Understanding the Limitations and Exclusions within Dental Insurance Plans.

12/02/17 6:10 AM

All dental insurance plans have some limitations and exclusions that is why it is very important to read each plans terms and conditions carefully to fully understand the benefits you receive as well as those you do not.

Dental insurance plans are designed to help with part of your dental expenses and may not always cover every dental need. The typical dental insurance plan includes limitations and exclusions, meaning the plan does not cover every aspect of dental care. Certain dental services my not be covered at all, where as others will have limited on whom is covered for that type of service or how many times you can have that type of dental service.

As an example of a limitation, you may find that the dental insurance plan covers for dental sealants but only for children under the age of 13. Maybe you are looking for braces, even though more and more adults are having orthodontic services many dental insurance plans will only provide benefits for braces to children 19 years of age or younger, assuming the plan even covers orthodontic treatment.   Another example of a limitation which is common in  most dental insurance plans is only being able to have one basic dental cleaning every six months or complete x-ray once a year.

Common exclusions in many dental insurance plans would be services such as teeth whiting, adult braces, veneers, dental implants etc.  You can see how read each plan term and conditions before buying one is very important.  Make sure the call member services if you have questions about a plans limitation and exclusions. Our member services are always happy to help you with any of or dental insurance or plan options Monday – Friday 8am to 4pm at 310-534-3444

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