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These Exclusions Are For The Following Ameritas Dental Plans

(This Includes Indemnity and PPO's)

Ameritas BrightOne Smart Plan - PPO
Ameritas BrightOne Access Plan 1000 and 1500 - PPO
Ameritas BrightOne Saver Plan 1000 and 1500 - Dental Indemnity Insurance
Ameritas BrightOne Traditional Plan 1000 and 1500 - Dental Indemnity Insurance
Ameritas BrightOne Advantage II Plan and Progressive Plan 1000 - Dental Indemnity Insurance

Comments that are highlighted in Blue are observations by Savon

There is no coverage:
  1.  For Preventive procedures, in the first 3 months that the Insured is covered under this section for Traditional and Access Plans.
  2.  For Basic procedures, in the first 6 months that the Insured is covered under this section.
  3. For Major procedures, in the first 12 months that the Insured is covered under this section for Traditional and Progressive Plans, and in the first 18 months for Access Plans.
  4. For any treatment which is for cosmetic purposes.  Facings on crowns or pontics beyond the second bicuspid are considered cosmetic).
  5. To replace any prosthetic appliance, crown, onlay restoration, or fixed partial denture within five years of the date of the last placement of these items.  But if a replacement is required because of an accidental bodily injury sustained while the Insured person is covered under this section, it will be a Covered Expense.
  6. For initial placement of any prosthetic appliance or fixed partial denture unless such placement is needed because of the extraction of one or more teeth while the Insured person is covered under this section.  But the extraction of a third molar (wisdom tooth) will not qualify under the above.  Any such appliance or fixed partial denture must include the replacement of the extracted tooth or teeth.
    Unless you have a tooth extracted while insured by this company, there is no benefit for any prosthetic appliance (dentures or partials) or fixed partial denture (bridges).

  7. For any procedure begun before the Insured person was covered under this section. 
  8. For any procedure begun after the Insured’s insurance under this section terminates;  or for any prosthetic dental appliances installed or delivered more than 90 days after the Insured’s insurance under this section terminates.
  9. To replace lost or stolen appliances.
  10. For appliances, restorations, or procedures to:
    • (10-A)  Alter vertical dimension
    • (10-B)  restore or maintain occlusion; or
    • (10-C) vsplint or replace tooth structure lost as a result of abrasion or attrition
  11. For any procedure which is not shown on the Table of Dental Procedures.
  12. For orthodontic treatment under this benefit provision.
    This is especially important for anyone in need of braces.

  13. For which the Insured person is entitled to benefits under any workers’ compensation or similar law, or charges for services or supplies received as a result of any dental condition caused or contributed to by an injury or sickness arising out of or in the course of any employment for wage or profit.
    Since Savon is not Insurance, if you have workers' compensation or are self-employed, you are still entitled to your Savon benefits.

  14. For charges for which the Insured person is not liable or which would not have been made had no insurance been in force.
  15. For services which are not required for necessary care and treatment or are not within the generally accepted parameters of care.
  16. Because of war or any act of war, declared or not.
Alternative Procedures.  If two or more procedures are considered adequate and appropriate treatment to correct a certain condition under generally accepted standards of dental care, the amount of the Covered Expense will be equal to the charge for the least expensive procedure.  This provision is NOT intended to dictate a course of treatment.  Instead, this provision is designed to determine the amount of the plan allowance for a submitted treatment when an adequate and appropriate alternative procedure is available.  Accordingly, the plan member may choose to apply the alternate benefit amount determined under this provision toward payment of the submitted treatment.

Orthodontia Limitations  for Progressive Plan, as noted in the policy.
  1. For a Program which was begun before the Insured became covered under this section.
  2. Before the Insured has been insured under this section for at least 12 consecutive months.
  3. In any quarter of a Program if the Insured was not covered under this section for the entire quarter.
  4. After the Insured’s insurance under this section terminates.
  5. For which the Insured is entitled to benefits under any workers’ compensation or similar law, or charges for services or supplies received as a result of any dental condition caused or contributed to by an injury or sickness arising out of or in the course of any employment for wage or profit.
  6. For charges which the Insured is not legally required to pay or which would not have been made had no insurance been in force.
  7. For services which are not required for necessary care and treatment or are not within the generally accepted parameters of care.
  8. Because of war or any act of war, declared or not
Updated 09/20/2016

Savon Dental Plan Is Not Available For Purchase In The State Of Florida
 
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