DENTAL - A82000 SERIES
In Arkansas, Policies A82100RAR through A82400RAR. In Idaho, Policies A82100RID through A82400RID. In New York, Policies NY82100 through NY82400. In Oklahoma, Policies A82100ROK through A82400ROK. In Oregon, Policies A82100ROR through A82400ROR. In Pennsylvania, Policies A82100RPAR through A82400RPAR. In Texas, Policies A82100RTX through A82400RTX. In Virginia, Policies A82100RVA through A82400RVA. Policies may not be available in all states. The policies have limitations and exclusions that may affect benefits payable. Refer to the policies for complete details, limitations, and exclusions. For costs, complete details of the coverage and for policies available in your state, please contact your local Aflac agent.
Limitations and Exclusions for residents of Arizona:
Aflac will not pay benefits for losses caused by or resulting from:
- Any procedure not shown on the Schedule of Dental Procedures.
- Services that are not recommended by a Dentist or that are not required for the preservation or restoration of oral health.
- Repairs to dental work within six months of the initial work.
- Replacement prosthetics within five years of last placement.
- Treatment involving crowns for a given tooth within five years of last placement, regardless of the type of crown.
- Replacement for inlays or onlays for a given tooth within five years of last placement.
- Treatment received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where your policy was issued.
- Treatment received prior to the Effective Date of coverage or treatment received during a benefit’s Waiting Period.
- A Dentist’s or dental practice’s failure to comply with the current ADA coding convention, including but not limited to upcoding, the overutilization of certain codes, and/or the misrepresentation of services (e.g., unbundling).
Benefits for sealants are limited to secondary molars for Dependent Children under age 16 and will not be payable more often than every five years. No benefits will be paid for replacement of teeth missing before the Effective Date of coverage. Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void.
Limitations and Exclusions for residents of Idaho:
Aflac will not pay benefits for losses caused by or resulting from:
- Any procedure not shown on the Schedule of Dental Procedures.
- Services that are not recommended by a Dentist or Denturist or that are not required for the preservation or restoration of oral health.
- Repairs to dental work within six months of the initial work.
- Replacement prosthetics within five years of last placement.
- Treatment involving crowns for a given tooth within five years of last placement, regardless of the type of crown.
- Replacement for inlays or onlays for a given tooth within five years of last placement.
- Treatment received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where your policy was issued.
- Treatment received prior to the Effective Date of coverage or treatment received during a benefit’s Waiting Period.
- A Dentist’s, Denturist’s or dental practice’s failure to comply with the current ADA coding convention, including but not limited to upcoding, the overutilization of certain codes, and/or the misrepresentation of services (e.g., unbundling).
Benefits for sealants are limited to secondary molars for Dependent Children under age 16 and will not be payable more often than every five years. No benefits will be paid for replacement of teeth missing before the Effective Date of coverage. Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void.
Limitations and Exclusions for residents of New Jersey:
Aflac will not pay benefits for losses caused by or resulting from:
- Any procedure not shown on the Schedule of Dental Procedures.
- Services that are not recommended by a Dentist or that are not required for the preservation or restoration of oral health.
- Treatment received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where your policy was issued.
- Treatment received prior to the Effective Date of coverage or treatment received during a benefit’s Waiting Period.
- A Dentist’s or dental practice’s failure to comply with the current ADA coding convention, including but not limited to upcoding, the overutilization of certain codes, and/or the misrepresentation of services (e.g., unbundling).
No benefits will be paid for replacement of teeth missing before the Effective Date of coverage. Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void.
Limitations and Exclusions for residents of Virginia:
Aflac will not pay benefits for losses caused by or resulting from:
- Any procedure not shown on the Schedule of Dental Procedures.
- Services that are not recommended by a Dentist or that are not required for the preservation or restoration of oral health.
- Repairs to dental work within six months of the initial work.
- Replacement prosthetics within five years of last placement.
- Treatment involving crowns for a given tooth within five years of last placement, regardless of the type of crown.
- Replacement for inlays or onlays for a given tooth within five years of last placement.
- Treatment received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where your policy was issued.
- Treatment received prior to the Effective Date of coverage or treatment received during a benefit’s Waiting Period.
- A Dentist’s or dental practice’s failure to comply with the current ADA coding convention, including but not limited to upcoding, the overutilization of certain codes, and/or the misrepresentation of services (e.g., unbundling).
Benefits for sealants are limited to secondary molars for Dependent Children under age 16 and will not be payable more often than every five years. No benefits will be paid for replacement of teeth missing before the Effective Date of coverage. Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void.
