Not Dentally Necessary
The plan provides benefits for those services and materials that it considers to be dentally necessary and meet generally accepted standards of care. Based on the information your dentist submits, the service may not appear to meet plan criteria and no benefit may be allowed. This does not mean that the services were not necessary. You or your dentist can appeal the benefit decision by submitting relevant information. The claim, along with the submitted information, should be reviewed by the plan's dental consultant.