Common use of Services Not Covered Clause in Contracts

Services Not Covered. The plan does not cover the following services: ➢ services that are not routinely performed by a dentist or denturist;. ➢ services that are not reasonable or necessary to maintain or restore teeth; ➢ services for which any benefits are payable under Workers' Compensation or any publicly supported plans; ➢ services not included in the dental or denturist fee schedules; ➢ services required because of war, riot, or self-inflicted injury, while sane or insane; ➢ services required because of participation in, attempt or commission of a criminal act; ➢ temporary dentistry, oral hygiene instruction, tissue grafts, services purely cosmetic in nature or used to correct congenital malformations; ➢ drug or medicines; ➢ services related to the functioning or structure of the jaw, jaw muscles or temporo mandibular joint; ➢ implants; ➢ replacement of lost or stolen orthodontia appliances; ➢ charges for appointments not kept; ➢ charges resulting from a change of dentist or denturist, unless approved by the plan carrier; ➢ charges for completing forms; ➢ charges for work in progress at the time the coverage for you and your dependents is terminated.

Services Not Covered. The plan Plan does not cover the following services: ➢ services that are not routinely performed by a dentist or denturist;. ➢ services that are not reasonable or necessary to maintain or restore teeth; ➢ services for which any benefits are payable under Workers' ’ Compensation or any publicly supported plans; ➢ services not included in the dental Dental or denturist fee schedulesDenturist Fee Schedules; ➢ services required because of war, riot, or self-inflicted injury, while sane or insane; ➢ services required because of participation in, attempt or commission of a criminal act; ➢ temporary dentistry, oral hygiene instruction, tissue grafts, services purely cosmetic in nature or used to correct congenital malformations; ➢ drug or medicines; ➢ services related to the functioning or structure of the jaw, jaw muscles or temporo mandibular joint; ➢ implants; ➢ replacement of lost or stolen orthodontia appliances; ➢ charges for appointments not kept; ➢ charges resulting from a change of dentist or denturist, unless approved by the plan carrier; ➢ charges for completing forms; ➢ charges for work in progress at the time the coverage for you and your dependents is terminated.

Services Not Covered. The plan does not cover the following services: ➢ ⮚ services that are not routinely performed by a dentist or denturist;. ➢ ⮚ services that are not reasonable or necessary to maintain or restore teeth; ➢ ⮚ services for which any benefits are payable under Workers' Compensation or any publicly supported plans; ➢ ⮚ services not included in the dental or denturist fee schedules; ➢ ⮚ services required because of war, riot, or self-inflicted injury, while sane or insane; ➢ ⮚ services required because of participation in, attempt or commission of a criminal act; ➢ ⮚ temporary dentistry, oral hygiene instruction, tissue grafts, services purely cosmetic in nature or used to correct congenital malformations; ➢ ⮚ drug or medicines; ➢ ⮚ services related to the functioning or structure of the jaw, jaw muscles or temporo mandibular joint; ➢ ⮚ implants; ➢ ⮚ replacement of lost or stolen orthodontia appliances; ➢ ⮚ charges for appointments not kept; ➢ ⮚ charges resulting from a change of dentist or denturist, unless approved by the plan carrier; ➢ ⮚ charges for completing forms; ➢ ⮚ charges for work in progress at the time the coverage for you and your dependents dependants is terminated.

Services Not Covered. The plan does not cover the following services: ➢  services that are not routinely performed by a dentist or denturist;. ➢  services that are not reasonable or necessary to maintain or restore teeth; ➢  services for which any benefits are payable under Workers' Compensation or any publicly supported plans; ➢  services not included in the dental or denturist fee schedules; ➢  services required because of war, riot, or self-inflicted injury, while sane or insane; ➢  services required because of participation in, attempt or commission of a criminal act; ➢  temporary dentistry, oral hygiene instruction, tissue grafts, services purely cosmetic in nature or used to correct congenital malformations; ➢  drug or medicines; ➢  services related to the functioning or structure of the jaw, jaw muscles or temporo mandibular joint; ➢  implants; ➢  replacement of lost or stolen orthodontia appliances; ➢  charges for appointments not kept; ➢  charges resulting from a change of dentist or denturist, unless approved by the plan carrier; ➢  charges for completing forms; ➢  charges for work in progress at the time the coverage for you and your dependents dependants is terminated.