Frequency and Limitation Grid — Dental plan frequency, limitations, maximums and exclusions
Defines calendar year maximums, orthodontia lifetime maximums, deductibles, service frequencies, limitations, and exclusions for Sierra Health & Life dental products; applies to members covered under the listed dental product codes.
No material clinical or coverage changes in this revision.
Coverage Criteria and Limitations
Coverage criteria and limitations
Per-plan frequency and limitation rules and exclusions
ALL of the following
- Exams: Two per calendar yearTwo per calendar year
Applies to listed plan variants (e.g. DLV P0900, P1300, P1400, P2200, PP301/303/400/500, etc.)
- Bitewing X‑rays: Two sets per calendar yearTwo sets per calendar year
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.