Orthodontic Age Limit Sample Clauses

Orthodontic Age Limit. No Age Limit No Age Limit No Age Limit * When you receive services from a Nonparticipating Dentist, the percentages in this column indicate the portion of Delta Dental's Nonparticipating Dentist Fee that will be paid for those services. The Nonparticipating Dentist Fee may be less than what your dentist charges and you are responsible for that difference. ➢ Oral exams (including evaluations by a specialist) are payable twice per calendar year. ➢ Prophylaxes (cleanings) are payable twice per calendar year. Periodontal maintenance procedures are not a Covered Service for people under age 16. ➢ People with specific at-risk health conditions may be eligible for additional prophylaxes (cleanings) or fluoride treatment. The patient should talk with his or her dentist about treatment. ➢ Fluoride treatments are payable twice per calendar year for people up to age 19. ➢ Space maintainers are payable once per area per lifetime for people up to age 16. ➢ Bitewing X-rays are payable twice per calendar year for people under age 19 and once per calendar year for people age APPENDIX I 19 and older. Full mouth X-rays (which include bitewing X-rays) are payable once in any five-year period. Vertical bitewing X-rays are payable once in any three-year period. ➢ Four periapical and two occlusal X-rays are payable per calendar year. ➢ Sealants are payable twice per tooth per lifetime for the occlusal surface of first and second permanent molars up to age

Orthodontic Age Limit. No Age Limit No Age Limit No Age Limit * When you receive services from a Nonparticipating Dentist, the percentages in this column indicate the portion of Delta Dental's Nonparticipating Dentist Fee that will be paid for those services. The Nonparticipating Dentist Fee may be less than what your dentist charges and you are responsible for that difference.  Oral exams (including evaluations by a specialist) are payable twice per calendar year.  Prophylaxes (cleanings) are payable twice per calendar year. One additional prophylaxis is payable in the same calendar year for individuals with a documented history of periodontal disease.  Fluoride treatments are payable once per calendar year for people up to age 26.  Space maintainers are payable once per area per lifetime for people up to age 16.  Bitewing X-rays are payable twice per calendar year. Full mouth X-rays (which include bitewing X-rays) are payable once in any three-year period.  Sealants are payable once per tooth per three-year period for the occlusal surface of first and second permanent molars up to age 16. The surface must be free from decay and restorations.  Veneers are payable on incisors and cuspids once per tooth per five-year period when necessary due to fracture or decay. Veneers for cosmetic purposes are not Covered Services.  Composite resin (white) restorations are Covered Services on posterior teeth.  Porcelain and resin facings on crowns are optional treatment on posterior teeth.  Full and partial dentures are payable once in any five-year period. Reline and rebase of dentures are payable once in any two-year period.  Implants and related services are not Covered Services. Having Delta Dental coverage makes it easy for you to get dental care almost everywhere in the world! You can now receive expert dental care when you are outside of the United States through our Passport Dental program. This program gives you access to a worldwide network of dentists and dental clinics. English-speaking operators are available around the clock to answer questions and help you schedule care. For more information, check our Web site or contact your benefits representative to get a copy of our Passport Dental information sheet. Maximum Payment – $1,500 per person total per Benefit Year on all services except orthodontic services. $1,000 per person total per lifetime on orthodontic services. Deductible – $50 Deductible per person total per Benefit Year limited to a maximum Deductible of $10...