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Texas Dental Plan (TDP) Limitations and Exclusions1

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Plan Exclusions and Limitations

  1. The following exclusions apply:

    a.     Services for injuries or conditions that are covered under Workman's Compensation, Employer's Liability Laws, or similar coverage;
    b.     Services which are provided without cost to the member by any municipality, county or other political subdivision;
    c.     Cost of dental care which is covered under automobile, medical, no fault, or similar type insurance;
    d.     General anesthesia (put to sleep), I.V. sedation, Nitrous Oxide, and hospitalization or hospital or medical charges of any kind; and
    e.     Osseointegrated implants.
     
  2. Member's dental fees apply only when treatment is performed at a participating dental office. If the services of a non-participating specialist or non-participating general dentist are required, these dental fees do not apply and the patient will be responsible to the non-participating dentist for his usual, customary and reasonable fee.
     
  3. Reduced fees will not be honored if dental treatment is already in progress or if the patient is no longer covered under the dental plan.
     
  4. Any member accepted for orthodontic treatment must remain a member of the dental plan for the full duration of their treatment or risk additional charges from their participating Orthodontist or General Dentist.
     
  5. A patient's existing dental or medical condition may necessitate extra precautionary procedures and require additional charges. Please discuss all fees with your dentist prior to treatment.
 

 

 

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