Dental Plans range from very comprehensive coverage or very limited coverage depending on the plan selection. Plans usually contain certain exclusions and limitations on coverage in an effort to control claim costs and to eliminate unnecessary dental care. There is usually a deductible amount that has to be met and some type of coinsurance payment arrangement as well as overall yearly and lifetime benefit maximums. The following treatments are usually covered under dental plans:
- Routine diagnostic procedures & preventative cleanings (max./yr)
- Restoration (including fillings and crowns)
- Oral surgery (including extraction of teeth)
- Endodontics (such as root canals)
- Periodontics (treatment of diseases of the gums)
- Prosthodontics (replacement of missing teeth)
- Limited orthodontic coverage (braces & retainers)
Carve-out vision benefits are typically provided under employer-provided medical expense plans. Normally, a benefit schedule is used that specifies the type and amounts of benefits and the frequency with which they will be provided. Vision care plans do not pay benefits for eye surgery or treatment of eye diseases because these are covered under the medical expense plan.