MMC Benefits Handbook
Restorative Exclusions
What are the restorative exclusions?
The Plan doesn't cover:
  • reimbursement for a temporary and a permanent crown is limited to the permanent crown charge
  • adjustments to dentures within six months of installation
  • specialized techniques, precision attachments, personalization or characterization of dentures
  • reimbursement for a temporary and a permanent denture is limited to the permanent denture charge
  • oral surgery postoperative
  • oral surgery treatment of fracture and dislocation of a tooth (may be covered under your medical plan)
  • orthognathic surgery (covered under your medical plan if medically necessary)
  • replacement of wisdom teeth
  • restorations to restore occlusion (chewing or grinding the surface of bicuspid and molar teeth), unless given in connection with orthodontic treatment
  • surgery for Temporomandibular Joint Syndrome (TMJ/TMD) (covered under your medical plan if medically necessary).