Common use of Allergies Clause in Contracts

Allergies. You are not covered for restorations or procedures necessary due to allergies or allergic reaction to dental treatment materials such as allergies to metals or mercury. You are not covered for local anesthesia or nitrous oxide (relative analgesia) when billed separately from the related procedure. This exclusion does not apply to general anesthesia or intravenous sedation administered in connection with covered oral surgery as described in the benefits section of this policy. You are not covered for any fees charged by your dental office because of broken appointments. Your plan does not cover the cost of cleaning removable partials or dentures. Charges for consultation are not a covered benefit. Your plan does not cover any charges to complete forms. You are not covered for services or supplies used for revision or alteration of the functional relationships between upper and lower teeth unless otherwise noted on the summary of benefits sheet at the front of this handbook. You are not covered for complications of a non-covered procedure.