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DeltaCare® Limitations and Exclusions

Limitations

The benefits are subject to the following limitations:

Exclusions

The following services are not covered by the Flagship prepaid dental plan:

Orthodontic Limitations and Exclusions

The program provides coverage for orthodontic treatment plans provided through DeltaCare panel orthodontists. The start-up fees and the cost to the enrollee for the treatment plan are listed in the Description of Benefits and Copayments (Schedule A) subject to the following:

 

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