Blue Cross Blue Shield FEP Dental
Class D Orthodontic

 

Services Not Covered

 

Refer to Section 7 for a list of general exclusions:
 
  • Repair of damaged orthodontic appliances
     
  • Replacement of lost or missing appliances
     
  • Services to alter vertical dimension and/or restore or maintain the occlusion. Such procedures include, but are not limited to, equilibration, periodontal splinting, full mouth rehabilitation, restoration for misalignment of teeth, or restoring tooth structure from attrition, erosion or abrasion.
     
  • Over-the-counter or mail order orthodontic treatments