Blue Cross Blue Shield FEP Dental Brochure - 2022

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