Dental Services Not Covered

The following expenses are not covered:

  • Charges for missed appointments or completion of dental claim forms
  • Prescription drugs
  • Replacement of teeth, unless medically necessary
  • Replacement of dentures, bridgework, crowns, or gold restorations less than five years old unless necessary because of disease or defect
  • Lost, misplaced, or stolen dentures
  • Replacement of an existing appliance unless:
    • Required because at least one additional tooth was necessarily extracted after the effective date of coverage
    • It replaces an existing appliance that is at least five years old and cannot be repaired, required as the result of accidental bodily injury
  • Cast crowns for children under age 12
  • Crowns for vertical dimension, to restore occlusion, bite registration, gnathology (jaw related), or periodontal (around the teeth) splinting
  • General anesthesia
  • Hospitalization expenses
  • Cosmetic treatments can be covered under certain circumstances, but only at one of the Plan’s Dental Health Centers
  • Occlusal adjustments, except for surgery or if included in orthodontic treatment unless necessary for periodontal purposes
  • Experimental dental treatments
  • Dietary planning services for oral hygiene/dental care
  • Any injury covered under Workers’ Compensation or similar legislation
  • Services payable under Medicare
  • Services covered under the Boston University Health Plan
  • Treatment furnished by a government or government agency, without charge, or by a member of your immediate family
  • Expenses resulting from:
    • A sickness or injury from an illegal activity, self-inflicted injury
    • War, declared or undeclared
    • Engagement in a riot or insurrection
  • Implantology
  • Emergency treatment does not include any final restorations (ie. root canal, crowns and dentures)