Short Description
Specific dental treatments or services that are not covered by a dental insurance policy, requiring the patient to pay full cost.
Long Description
Exclusions are dental services or treatments that an insurance plan does not cover, meaning the policyholder must pay the full cost out-of-pocket. Each insurance plan has a list of exclusions, which can include elective procedures, cosmetic treatments, or certain experimental treatments.
Common exclusions in dental insurance plans may include:
Cosmetic procedures (teeth whitening, veneers)
Orthodontics (unless the plan includes orthodontic coverage)
Dental implants (some plans do not cover them)
Replacement of lost or stolen dentures
Services exceeding plan limitations (e.g., more than two cleanings per year)
Understanding exclusions helps patients avoid unexpected costs. Reviewing the certificate of coverage or contacting the insurance provider before treatment ensures clarity on what services are covered and which are excluded.