Common use of Loss of Eligibility During Treatment Clause in Contracts

Loss of Eligibility During Treatment. If a Member loses eligibility while receiving dental treatment, only Covered Services received while that person was covered under This Plan will be payable. Certain services begun before the loss of eligibility may be covered if they are completed within 60 days from the date of termination. In those cases, Delta Dental evaluates those services in progress to determine what portion may be paid by Delta Dental. The difference between Delta Dental’s payment and the total fee for those services is your responsibility. This provision does not apply to orthodontics if covered under This Plan.