What are the limitations and exclusions for dental and orthodontic services coverage?

Dental and orthodontic services coverage under NC DMA may have certain limitations and exclusions. Limitations typically vary based on the specific plan, but common examples include restrictions on the number of visits or treatments covered within a certain timeframe, limitations on certain procedures or services, and requirements for prior authorization or referrals. Exclusions refer to services and treatments that are generally not covered by the plan. These can include cosmetic procedures such as teeth whitening, orthodontic services solely for cosmetic purposes, dental implants, and certain other elective treatments. It is important to thoroughly review your specific plan documents and consult with the NC DMA or your dental provider to fully understand the limitations and exclusions applicable to your coverage.