Principal Dental PPO Exclusions, Limitations, Frequencies, and Missing Tooth Clause
Dental insurance policies come with many rules, and fine print. These regulations can be hard to understand. Sunnyvale Dentist Dr. Antonious and the Sunnyvale Dental Care team deal with many insurance companies every day and know what to look for. Many patients at Sunnyvale Dental Care have coverage through Principal Dental PPO insurance. There are a variety of plans available through this company. We will be happy to contact Principal Dental PPO insurance on your behalf to get the details of your individual policy.
Each Principal Dental PPO insurance plan gives its members an annual maximum amount that they can spend towards dental care, but the way that it is spent is not entirely up to the patient. For example, some dental treatments may be excluded especially cosmetic treatments like teeth whitening. Crowns, veneers, and bonding done strictly for cosmetic purposes may also be excluded by many dental insurance carriers. Other common exclusions are night guards and dental implants.
Another coverage rule on some dental insurance policies is, “The replacement of teeth lost prior to the insurance start date is not a covered expense.” This is known as a Missing Tooth Clause. Fortunately this clause does not exist on every insurance plan.
Dental insurance companies also decide how often procedures can be done. A patient may be limited to two dental cleanings per year at a frequency of every six months. Cavity detecting bitewing x-rays may be limited to once per year.
Missing teeth can be replaced through fixed bridges, implants, partial dentures, or full dentures. Some insurance policies stipulate which teeth replacement options are covered expenses and which are not.
Because there are such a wide variety of dental insurance plans on the market, the only way to know the exclusions, limitations, and rules of your plan is to contact Principal Dental PPO insurance and request eligibility information including a breakdown of benefits. Sunnyvale Dentist Dr. Antonious will have his staff handle this for you prior to your visit.