{"id":307,"date":"2020-11-24T15:14:29","date_gmt":"2020-11-24T15:14:29","guid":{"rendered":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/?page_id=307"},"modified":"2020-11-27T23:15:42","modified_gmt":"2020-11-27T23:15:42","slug":"dental-what-is-not-covered","status":"publish","type":"page","link":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/dental-what-is-not-covered\/","title":{"rendered":"Dental &#8211; What Is Not Covered"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221;][et_pb_row column_structure=&#8221;2_3,1_3&#8243; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221;][et_pb_column type=&#8221;2_3&#8243; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221;][et_pb_text admin_label=&#8221;not covered&#8221; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;16px&#8221; hover_enabled=&#8221;0&#8243; sticky_enabled=&#8221;0&#8243;]<\/p>\n<h2>Dental<\/h2>\n<h3>What Is Not Covered<\/h3>\n<p><strong>We will not pay Dental Insurance benefits for charges incurred for:<\/strong><\/p>\n<ol class=\"left-list\">\n<li>services which are not Dentally Necessary, or those which do not meet generally accepted standards of care for treating the particular dental condition;<\/li>\n<li>services for which You would not be required to pay in the absence of Dental Insurance;<\/li>\n<li>services or supplies received by You or Your Dependent before the Dental insurance starts for that person;<\/li>\n<li>services which are neither performed nor prescribed by a Dentist, except for those services of a licensed Dental Hygienist which are supervised and billed by a Dentist, and which are for;\n<ul style=\"padding-left:40px;\">\n<li>scaling and polishing of teeth; or<\/li>\n<li>flouride treatments<\/li>\n<\/ul>\n<\/li>\n<li>services which are primarily cosmetic, (For residents of Texas, see notice page section);<\/li>\n<li>services or appliances which restore or alter occlusion or vertical dimension;<\/li>\n<li>restoration of tooth structure damaged by attrition, abrasion or erosion, unless caused by disease;<\/li>\n<li>restorations or appliances used for the purpose of periodontal splinting;<\/li>\n<li>counseling or instruction about oral hygiene, plaque control, nutrition and tabacco;<\/li>\n<li>personal supplies or devices including, but not limited to: water piks, toothbrushes, or dental floss;<\/li>\n<li>initial installation of a Denture or implant to replace one or more teeth which were missing before such person was insured for Dental Insurance, except for congentially missing teeth;<\/li>\n<li>decoration or inscription of any tooth, device, appliance, crown or other dental work;<\/li>\n<li>missed appointments;<\/li>\n<li>services:\n<ul style=\"padding-left:40px;\" >\n<li>covered under any workers&#8217; compensation or occupational disease law;<\/li>\n<li>covered under any employer liability law;<\/li>\n<li>for which the Employer of the person receiving such services is required to pay; or<\/li>\n<li>received at a facility maintained by the Policyholder, labor union, mutual benefit association, or VA hospital;<\/li>\n<\/ul>\n<\/li>\n<li>services covered under other coverage provided by the Policyholder;<\/li>\n<li>biopsies of hard or soft oral tissue;<\/li>\n<li>temporary or provisional restorations;<\/li>\n<li>temporary or provisional appliances;<\/li>\n<li>prescription drugs;<\/li>\n<li>services for which the submitted documentation indicates a poor prognosis;<\/li>\n<li>the following, when charged by the Dentist on a separate basis:\n<ul style=\"padding-left:40px;\" >\n<li>claim for completion;<\/li>\n<li>infection control, such as gloves, masks, and sterilization of supplies, or<\/li>\n<li>local anesthesia, non-intravenous conscious sedation or analgesia, such as nitrous oxide;<\/li>\n<\/ul>\n<\/li>\n<li>dental services arising out of accidental injury to the teeth and supporting structures, except for injuries to the teeth due to chewing or biting of food;<\/li>\n<li>caries susceptibility tests;<\/li>\n<li>labial veneers;<\/li>\n<li>modification of removable prosthodontic and other removable prosthetic services;<\/li>\n<li>appliances or treatment for bruxism (grinding teeth);<\/li>\n<li>adjustment of a Denture made within 6 months after installation by the same Dentist who installed it;<\/li>\n<li>duplicate prosthetic devices or appliances;<\/li>\n<li>replacement of a lost or stolen appliance, Cast Restoration or Denture;<\/li>\n<li>replacement of an orthodontic device;<\/li>\n<li>diagnosis and treatment of temporomandibular joint disorders and cone beam imaging associated with the treatment of temporomandibular joint disorders;<\/li>\n<li>intra and extraoral photographic images.<\/li>\n<\/ol>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221;][et_pb_text admin_label=&#8221;dental side link&#8221; _builder_version=&#8221;4.6.6&#8243; _module_preset=&#8221;default&#8221; global_module=&#8221;283&#8243; saved_tabs=&#8221;all&#8221;]<\/p>\n<h3>Dental<\/h3>\n<p><strong>Related Pages<\/strong><\/p>\n<ul>\n<li><a href=\"http:\/\/schooldistrictbenefits.com\/redclay\/n\/dental-what-is-covered\/\">What Is Covered<\/a><\/li>\n<li>What Is Not Covered<\/li>\n<li>Dependent Coverage<\/li>\n<li>When Coverage Ends for a Dependent Child<\/li>\n<li>Orthodontia<\/li>\n<li>When Your Coverage Ends<\/li>\n<li>Glossary of Dental Terms<\/li>\n<\/ul>\n<p><strong>Related Links &amp; Forms<\/strong><\/p>\n<ul>\n<li><a href=\"http:\/\/schooldistrictbenefits.com\/redclay\/forms\/Red%20Clay%20School%20District%20%202018%20Progressive%20Maximum%20Plan%20-%202-Tier-Standard.pdf\">Cigna Dental Benefit Summary<\/a><\/li>\n<li><a href=\"http:\/\/schooldistrictbenefits.com\/forms\/DentalCigna%20B2C%20Directory%20Find%20a%20Dentist%20Open%20Enrollment%20Flyer.pdf\">Cigna<\/a><\/li>\n<li><a href=\"http:\/\/schooldistrictbenefits.com\/forms\/myCigna-Registration%20Steps%20Flyer.pdf\">myCigna.com<\/a><\/li>\n<li><a href=\"http:\/\/schooldistrictbenefits.com\/redclay\/forms\/DPPO%202%20Tier%20Progressive%20Maximum%20-%20CSDD%20Red%20Clay%202017.pdf\">Cigna Dental Plan Brochure<\/a><\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dental What Is Not Covered We will not pay Dental Insurance benefits for charges incurred for: services which are not Dentally Necessary, or those which do not meet generally accepted standards of care for treating the particular dental condition; services for which You would not be required to pay in the absence of Dental Insurance; [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-307","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/pages\/307","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/comments?post=307"}],"version-history":[{"count":12,"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/pages\/307\/revisions"}],"predecessor-version":[{"id":326,"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/pages\/307\/revisions\/326"}],"wp:attachment":[{"href":"http:\/\/schooldistrictbenefits.com\/redclay\/n\/wp-json\/wp\/v2\/media?parent=307"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}