MMC Benefits Handbook
What's Not Covered
General Exclusions
What are the general exclusions?
The Plan doesn't cover:
- cosmetic treatment
- replacement for accidental injured teeth (contact your medical plan claims administrator to find out whether services are covered under your medical plan)
- treatment covered under any other plan sponsored by Marsh McLennan (other than through a health care flexible spending account or health savings account)
- treatment furnished in a US government hospital
- treatment performed before the employee or family member was covered by the Plan
- services not performed by a dentist except for those services of a licensed dental hygienist which are supervised and billed by a dentist for scaling and polishing of teeth; or fluoride treatments
- treatment required because of teeth grinding (except for occusal guards)
- services or supplies which are covered by any workers' compensation laws or occupational disease laws
- services or supplies, which are, covered by any employers' liability laws
- services or supplies which any employer is required by law to furnish in whole or part
- services or supplies for which no charge would have been made in the absence of dental benefits
- services or supplies which are deemed experimental in terms of generally accepted dental standards
- use of materials or home health aids to prevent decay, such as toothpaste or fluoride gels, other than topical application of fluoride
- instruction for oral care such as hygiene or diet
- charges by the dentist for completing dental forms
- sterilization supplies
- charges for broken appointments
- treatment that would otherwise be free to you.