Exclusions, also known as limitations or cost containment, are the dental services and procedures that are not covered by dental insurance. Dental plans may use the terms "Usual, Customary and Reasonable" (UCR) to determine the portion of the dental treatment fee they are willing to pay for. All dental insurance plans can differ in exclusions. Even some pre-existing conditions are excluded from coverage. See Momentum's Exclusions policy.
Why do insurance companies have exclusions?
Exclusions are used for certain risks that usually can be controlled by the policyholder. There are several factors that determine exclusions, including:
- Damage from lack of regular maintenance
- Issues that result from illegal or criminal acts
- Damage caused by intentional actions