Metlife missing tooth clause

What does no missing tooth clause mean? Does MetLife cover dental implants? Are dentures considered orthodontics? MetLife denied my claim due to the missing tooth clause. My partial cost $ 500.

I had my dentist office send MetLife a narrative and xrays. MetLife Dental PPO Missing Tooth Clause , Limitations, Exclusions, and Frequencies. Metlife Veterans Affairs Dental Plan. The exclusions in this section apply to all benefits.

Although we may list a specific service as a benefit, we will not cover it unless we determine it is necessary for the prevention, diagnosis, care, or treatment of a covered condition. Benefits provided by SafeGuard Health Plans, Inc. This SCHEDULE OF BENEFITS lists the Covered Services available to You and Your Dependents under Your dental plan, as well as Your and Your Dependent’s costs for each Covered Service. If you are missing a tooth and are looking to get a bridge or an implant to replace the missing tooth , your policy may have a ‘ missing tooth clause ’. This means if you had the tooth extracted prior to enrolling with your current policy, they will not pay any benefits towards restoring that tooth. Emergency palliative treatment to relieve tooth pain.

Initial placement of amalgam or resin fillings. I did a search and found only dated threads on federal dental insurance. We are considering FEP BlueDental, MetLife (standard or high), and United Concordia. Our current dentists are in network for these plans. Just ask anyone who has been told their plan has a “ missing tooth clause.

What is a missing tooth clause exactly? When a company has a provision in their contract that states that if a tooth is lost before the contract begins, they don’t bear any responsibility to cover replacing the tooth. A missing tooth clause explains any coverage limitations related to teeth missing or extracted prior to your effective date of coverage. The missing tooth clause can vary depending upon your plan, so be sure to check your certificate of coverage for details. Dental The Dental Plan helps you pay for a wide range of dental services, from preventive care and cleanings to more extensive dental work, including crowns and dentures.

An online, easy to use, interactive program designed to help you understand your risk for oral disease and your current dental health status, with the goal of helping you improve your oral health. Included in their Dental PPO plan is full service coverage for retirees, a big plus when enhancing retirement benefits. Missing Tooth Clause : If a dental insurance policy has a missing tooth clause , tooth replacement will only be covered if a tooth was extracted or lost while the policy was active.

Dental Insurance Plans Without A Missing Tooth Clause. If a tooth was extracted during a period where a patient had no insurance or was covered by a different insurance company, an implant, partial denture, or bridge. Any dental service started and completed prior to Effective Date. Thanks to our advanced software programs and vast experience of our insurance coordinators, we can help you use your dental insurance to cover most or all of the costs for your care. The details of your individual Aetna PPO Dental plan can be accessed by the insurance professionals at Sunnyvale Dental care.

They will pay careful attention to any exclusions, limitations, and missing tooth clause contained in your plan. Most patient are seeking help with major coverage when purchasing self-funded policies. If part of your plan is to have teeth replaced with this new policy, please ask this question. If a missing tooth clause is in place the policy will not pay to replace any teeth that were missing prior to the effective date of the policy.

Delta Dental Premier dentists offer moderate savings if an enrollee chooses to go outside the PPO network. Delta Dental PPO dentists are the “in-network” choice for a PPO plan, and usually offer the deepest discounts. A titanium rod surgically placed in the bone of the upper or lower jaw to provide support for a dental restoration or appliance (such as a crown). An artificial device, such as a bridge, that replaces one or more missing teeth.

The inner layer of tooth structure, located immediately under the surface. Contact Member Services if you have questions. Are there any restrictions in replacing my missing teeth ? If the teeth were lost or extracted before your coverage began, then services to replace them may not be covered by your plan.