Covered Major Services

• replacement of existing partial or full removable denture(s) providing:
  a) the replacement is more than 12 months after the individual became insured under this coverage, and the existing appliance is at least 5 years old and cannot be made serviceable; or,
  b) the existing appliance is replaced as a result of extraction, loss of one or more sound natural teeth after the individual became insured under this Trust Fund, or the initial placement of an opposing denture.
  Replacement of lost or stolen dentures, the duplication of dentures and personalization or characterization of dentures is not covered. A temporary appliance is considered to be permanent if not replaced within 12 months from the date the temporary appliance was inserted.
• repair or recementing of crowns, inlays or fixed prosthetics
• extensive oral surgery
• injection of antibiotic drugs
• metal inlays, onlays and crowns, used to restore natural teeth to their normal functions where the tooth, as a result of extensive caries or fracture, cannot be restored with a filing. When a tooth can be restored with silver amalgam, silicate or synthetic restorations, benefits will be determined based on the usual costs of such a restoration.
• initial installation of fixed bridgework
• bridge repairs and recementation
• replacement of existing fixed bridgework providing:
  a) the replacement is more than 12 months after the individual became insured under this coverage, and the existing fixed prosthetic device is at least 5 years old and cannot be made serviceable; or,
  b) the replacement is required because of extraction, loss or fracture of one or more sound natural teeth after the individual became insured under this Trust Fund.
  A temporary bridge is considered to be permanent if not replaced within 12 months from the date the temporary bridge was inserted.
• Alternative Benefits; Alternative benefits will be provided for the following appliances based on coverage for standard denture or bridgework related to implants.