Major Restorative Care Services

Crowns/inlays/onlays (one per tooth per five calendar years);
Root canal treatments (Please Note: The PDP Option covers root canal as a Major Restorative Care Service. The Dental DMO/DHMO Option covers root canal as a Basic Care Service.);
Injections of antibiotic drugs (Please Note: The DMO Option covers injections of antibiotic drugs as a Major Restorative Care Service. The PDP and DHMO Options cover injections of antibiotic drugs as a Basic Care Service.);
Only appliances related to temporomandibular joint dysfunction (TMJ) (PDP and DMO: subject to a lifetime maximum of $500; the DHMO covers one appliance per 24 months, not subject to a lifetime maximum).
Initial placement and replacement of dentures and bridges — if the original appliance is at least five years old and cannot be repaired;
Services necessary to replace teeth lost while coverage is in effect;
Treatment for harmful habits as described and determined by the claims administrator;
Treatment for accidental injury (eligible dental expenses are covered under the Dental Plan; eligible medical expenses are covered under the Medical Plan.); and
Implant(s). Benefits may also be available for the final restoration or prosthesis (crown or partial denture) over the implant. A pre-treatment estimate should be submitted for a dental consultant to evaluate the claim to determine if any benefits are payable.