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Orthodontic Covered Services
Orthodontia is covered for a child under age 19 if the orthodontic appliance is initially installed while dental coverage is in effect for the child. The orthodontic appliance is a device used for influencing tooth position and may be classified as fixed or removable, active or retaining, and intraoral or extraoral.
Orthodontic treatment generally consists of the initial placement of an appliance and periodic follow-up. It also includes other services required for the orthodontic treatment such as extractions of certain teeth.
The benefit payable for the initial placement will not exceed 20% of the amount charged by the dentist. If the initial placement was made before the child's becoming covered under the JPMorgan Chase Dental Plan, the benefit payable will be reduced by the portion attributable to the initial placement.
The benefit payable for periodic follow-up visits will be payable on a monthly basis during the course of the orthodontic treatment if:
  • Dental coverage is in effect for the child receiving the orthodontic treatment; and
  • Proof is given to MetLife that the orthodontic treatment is continuing.
If the periodic follow-up visits began before the child's becoming covered under the JPMorgan Chase Dental Plan:
  • The number of months for which benefits are payable will be reduced by the number of months of treatment performed before the child became covered under the JPMorgan Chase Dental Plan; and
  • The total amount of the benefit payable for the periodic visits will be reduced proportionately.