Treatment Exclusions
Depending on the patient's insurance plan, certain procedures or preventative measures may not be covered. Examples of procedures that may not be covered include sealants, implants, pre-existing conditions, and adult orthodontics.
Frequency Limitations
The terms of a dental plan may stipulate limits on certain procedures. One common example is of a patient who needs dental cleanings four times per year when the plan only covers two visits.
Comprehensive Alternative Treatments
Some dental plans may cover only the least expensive solution for a given condition. Your dentist may recommend a procedure for which there is a cheaper alternative, with your insurance covering only the cheaper procedure. Patients should base the use of their dental benefits on their specific needs, rather than the costs involved. In many situations, the less expensive procedure is not the best option for the patient.