2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 93
(17) Oral Hygiene: Expenses for oral hygiene, dietary or plaque control programs, or other educational programs
will not be considered eligible.
(18) Personalization: Expenses for personalization of dentures will not be considered eligible.
(19) Prior to Effective Date: Expenses which are Incurred prior to the effective date of your coverage under the
Plan will not be considered eligible.
(20) Splinting: Expenses for crowns, fillings or appliances that are used to connect (splint) teeth, or change or
alter the way the teeth meet, restoring the bite (occlusion) or are cosmetic will not be considered eligible.
(21) Take Home Items: Expenses for mouth guards or take home items will not be considered eligible.
(22) Temporary Prosthesis: Expenses for a temporary full prosthesis or for adjustment or relining of a prosthesis
within 6 months after the prosthesis is initially furnished will not be considered eligible.
(23) Temporomandibular Joint Dysfunction (TMJ): Expenses Incurred for appliances or restorations in
connection with Temporomandibular Joint Dysfunction (TMJ) or myofunctional therapy will not be considered
eligible. Please see Eligible Medical Expenses for Covered Expenses.
(24) Vision Care: Expenses for vision care, including professional services for the fitting and/or supply of lenses,
frames, contact lenses and other fabricated optical devices that exceed $250 will not be considered eligible
for reimbursement. Routine eye exams will be covered as specified under Eligible Medical Expenses under
the Medical Plan.
(25) Usual and Customary Charges: Expenses in excess of the Usual and Customary Charge will not be
considered eligible.
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