Dental plan limitations and exclusions
The following is a summary of ODS dental plan limitations and exclusions effective November 1, 2011. This is a benefit summary only. For a complete description of benefits, limitations and exclusions, refer to the individual policy.
- Examinations are limited to once every six months.
- Bitewing X-rays are limited to once every 12 months.
- Full mouth X-rays are limited to once every five years.
- Prophylaxis (cleaning) is limited to once every six months.
- Fluoride application is limited to once every 12 months for members younger than age 19; once every 12 months for members age 19 and up if there is a history of periodontal disease or high risk of decay.
- Surgical placement or removal of implants is not covered.
- Orthodontic services are not covered.
- Services for cosmetic reasons are not covered.
- There is a waiting period on Class III restorative and prosthodontic services
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