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, and restoration for misalignment of teeth.
     
  • Over-the-counter or mail order orthodontic treatments