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| EXTENSION OF BENEFITS |
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Benefits will continue to be provided for dental services provided to a patient who is totally disabled when coverage ends if:
- the Dentist recommends the services to the patient in writing and the services began while the coverage was in effect;
- the services are not for routine examinations, prophylaxis, x-rays, sealants, or orthodontic services;
- the services are provided within 90 days after the patient's coverage ended, and the coverage did not end because the patient (or, in the case of a dependent child, the child's parent) voluntarily terminated coverage.
The extension of Benefits ends at the earlier of:
- the end of the 90-day period in 3) above; or
- the date the patient becomes covered under a succeeding policy.
However, if coverage for the dental services described in this Extension of Benefits provision are excluded by the succeeding policy through the use of an elimination period or limitations and the patient is not covered by the succeeding policy, the extension of Benefits does not terminate.
All contractual limitations, exclusions or reductions that would have applied to the specific dental services had this coverage not terminated apply during the extension of Benefits. |
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© 2008 Delta Dental |
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