What's not covered?
- Any procedure that is not specifically listed in the plan contract
- Treatment provided by any dentist who is not your assigned DeltaCare® USA contract dentist, except for emergency and preauthorized specialty care
- General/IV sedation
- Occlusal mouth guards
- Brush biopsy
- Implants
Review the Limitations and Exclusions sections within the plan contracts for full plan details.
Disclosure Form/Contract
Detailed disclosure of plan copayments, limitations and exclusions.
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