The policy under which your certificate will be issued covers services and procedures as described in the Coverage Schedule. Your coverage under the policy does not cover any miscellaneous separate expense not considered a covered service or procedure.

No benefits will be paid for expenses incurred:

1. for charges in excess of those considered reasonable or customary.
2. for cosmetic procedures.
3. for replacement of dentures, bridges, inlays, onlays or crowns that can be repaired or restored to normal function.
4. for replacement of lost or stolen appliances; or for:
   1. replacement of retainers;
   2. athletic mouth guards;
   3. precision or semi-precision attachments;
   4. denture duplication; or
5. for oral hygiene instructions; or for;
   1. plaque control
   2. completion of a claim form;
   3. acid etch;
   4. broken appointments;
   5. prescription or take-home fluoride; or
   6. diagnostic photographs
6. for services not completed by the end of the month in which coverage ends, unless continuation of coverage has been requested and accepted by Us.
7. for procedures that are begun, but not completed.
8. for services and treatment provided without charge for which there would be no charge in the absence of insurance.
9. for services in connection with war or any act of war, whether declared or undeclared, or condition contracted or accident occurring while on full-time active duty in the armed forces of any country or combination of countries.
10. for a condition covered under any Worker's Compensation Act or similar law.
11. that are applied toward satisfaction of a Deductible, if any.
12. that are generally considered by the dental profession as experimental or investigational.
13. for the treatment of the cleft palate and anodontia.
14. for services or supplies payable under any medical expense plan.
15. for orthodontia, unless included by rider.
16. prior to the date the Insured is covered under the Policy.
17. for the diagnosis of treatment of TMJD.
18. for hospital services.
19. for any unmarried child age 19 years of age and over, unless he is dependent upon You for support, while a full-time student. A full-time student who is enrolled for 12 semester hours for credit in an accredited junior college, college or university. Any exception for a full-time student will end at age 23.
20. if you and/or any Dependents do not apply for coverage on Your initial eligibility date, a 24 month waiting period must be completed to be eligible for Basic and Major Care.
21. for services related to self inflicted injuries.
22. for services related to commission of a felony or an assault on another person.
23. for services related to a riot.
24. for periodontal splinting.
25. for replacement of partial or full dentures, fixed bridgework, crowns, gold restorations and jackets more often than once in any 5 year period.
26. for services related to fixed or removable bridgework replacement of a natural tooth or teeth, which was lost prior to the Insured's effective date of coverage under the Policy. Benefits may be payable for bridgework required for loss of teeth while insured under the Policy, if such bridgework is not an abutment for non-covered bridgework.
27. for services related to counseling on a diet and nutrition.
28. for services received from a provider who is a relative, or living with the member or who is acting outside the scope of his license.
29. for bite registrations.
30. for bacteriologic cultures in connection with a covered Dental service.
31. for therapeutic injections administered by a Dentist.
32. for restorations on the same tooth more than once in a 2 year period.
33. for restorations necessary to correct vertical dimension or to restore the occlusion.
34. for root planning or sub-gingival curettage (but not both) more than once in a 12 month period.
35. for night guards and occlusal splints.
36. for root canal treatment on the same tooth more than once in any two year period.
37. for stainless steel crowns not more than once in any two year period.
38. for study models.
39. for a crown used as an abutment to a partial denture unless the tooth is decayed or fractured to the extent that a crown would be required to restore the tooth whether or not a partial denture was required.
40. for veneers.