*Prosthodontic, Major Restorative, Bridges & Dentures
Dental benefits are capped at a plan year limit of $1,500 ($3,000 in claims) per person. Any dental co-insurance, shared payment or maximum benefit limits are not applied toward the maximum out-of-pocket expense for medical.
Note: Orthodontics is excluded from coverage.
*There is a waiting period of 240 days of continuous coverage for these services. ("Continuous Coverage" means coverage for the service under this plan.) The waiting period does not apply to these services when required as a result of an accidental injury occurring after the covered person's effective date.
All claims are paid based on the "allowable charge." (Allowable charge is the prevailing charge in the area for care of a comparable nature, by a person of similar training and experience.)