What are Best Life Dental Exclusions on Coverage?

Written By Tarek El Ali (Super Administrator)

Updated at November 22nd, 2021

For a complete listing of benefits, exclusions, and limitations please refer to your policy. In the event of any discrepancies contained in the exclusions below, terms and conditions in the policy documents shall govern. This brochure provides only a summary of information and the benefits and rates may vary by state.

Exclusions: The dental policies provided by Best Life Dental excludes and will not reimburse for the following services or charges.

  • Services provided by anyone other than a doctor of medical dentistry or a doctor of dental surgery, unless a licensed hygienist performs the services under the direction of a doctor of medical dentistry or a doctor of dental surgery, or a dentist.
  • Services received while on active duty with a military service of any country or international organization.
  • Services needed because of participation in a riot or insurrection or the commission of a felony.
  • Services needed as a result of a work related injury or illness, whether or not covered under Worker's Compensation.
  • Services provided by an employer.
  • Services started before your effective date. Examples of excluded services under this paragraph include but are not limited to the following: obtaining an impression for an appliance, or a modification of one, before your effective date; preparing a tooth for a crown, bridge or other lab fabricated restorations before your effective date; opening a pulp chamber for root canal therapy before your effective date.
  • Services required because you failed to comply with professionally prescribed treatment. 
  • Telephone consultation services.
  • Charges for your failure to keep a scheduled appointment.
  • Services that are primarily for cosmetic reasons. Examples include alteration or extraction of functional natural teeth for the purpose of changing appearance and replacement of restorations previously performed for cosmetic reasons. 
  • Services for Orthodontic treatment and orthodontia type procedures unless this policy defines those services as covered services.
  • Services received for or related to temporomandibular joint dysfunction (TMJ).
  • Charges in excess of the agreed to coverage amounts as shown on the schedule of benefits.
  • Services for correction or alteration of occlusion or any occlusal adjustments. Expenses incurred for night guards or any other appliance for the correction of harmful habits, except as defined as a Covered Dental Expense.
  • Charges for "safe fees" (e.g. gloves, masks, surgical scrubs, and sterilization)
  • Charges for state or territorial taxes associates with dental services.
  • Charges for services received from two or more providers for a single procedure or a course of care. If those charges would have been less if received from one provider and you made the decision to transfer your care during the procedure or course of care.
  • Services that are experimented or investigational.
  • Services that are not within the treating provider scope of practice/.
  • Charges for treatment at a hospital.
  • Charges for plaque control programs, oral hygiene instructions, and dietary instructions.
  • Services received outside the United States.
  • Charges for gold foil restorations
  • Charges to replace missed, stolen, or damaged dentures.