TriCare Delta Dental Exclusions, Limitations, Frequencies and Missing Tooth Clause
TriCare Delta Dental insurance provides many excellent savings options for patients who have purchased one of its many plans. Each TriCare Delta Dental insurance policy will have a set amount that is available for use per person per year. To receive the best savings possible, you will want to have your dental treatment done by a dentist who is an in network provider for TriCare Delta Dental. Sunnyvale Dentist Dr. Antonious has been a preferred provider in the TriCare Delta Dental network for many years. Besides lower fees, you can expect quality care when your dental treatment is done at Sunnyvale Dental Care.
When you call or stop by to schedule your appointment, the Sunnyvale Dental Care office team will ask for the identification number used to find you in the TriCare Delta Dental insurance patient portal. This will allow them to access the details of your chosen policy. They will make you aware of any exclusions, limitations, frequency rules or clauses found under your policy.
An example of a common rule or clause is a “Missing Tooth Clause.” It stipulates that if a tooth is extracted prior to purchasing the insurance policy, the tooth replacement cost may not be a covered benefit. Fortunately this clause does not exist on every dental insurance policy, but if it does on yours we’ll be sure to let you know.
Sunnyvale Dentist Dr. Antonious will also have his team verify which services you are eligible for, such as cleanings, x-rays, and examinations. Cleanings and exams may be limited to twice per year, and cavity detecting x-rays may be limited to once or twice per year.
Some insurance policies have a waiting period for certain services. This is especially true of plans that are not provided by an employer, but that have been purchased directly from the insurance company. It is not uncommon in these instances for basic and or major treatment to have a waiting period that could range from six months to one year or even longer. Examples of basic services are fillings, extractions, deep cleanings, root canals, crowns, bridges, dentures, and dental implants.