# dental frequency limitations Answer: A frequency limitation caps how often a plan pays for a service, and it is a contract term rather than a payer standard: Guardian publishes no frequency figure at all and states that plan documents are the final arbiter of coverage, and Aetna publishes no crown frequency baseline in any of its dental clinical policy bulletins. Verified in named documents: crown replacement windows run from 24 months to 10 years — 24 and 36 months for prefabricated and stainless steel crowns on one Guardian Utah plan, 36 months in South Carolina Medicaid, five years on Aetna's California DMO and in both United Concordia government programs, 60 months on one Delta Dental Insurance Company group PPO, 84 months in Colorado Medicaid, and 10 years on one MetLife-authored plan-summary form. Preventive rules differ in kind as well as number: one DentaQuest Ohio policy gives under-19 members a six-month interval and adults twice per calendar year, one Delta group plan pays examinations, cleanings, periodontal maintenance, and scaling in the presence of inflammation twice per calendar year in any combination, and MetLife's federal plan moved routine exams and cleanings from one in six months to two in twelve months for 2026 while capping replacement fillings at one in 24 months. The counting method matters as much as the allowance — calendar year, rolling 12 months, or six months from the last date of service — and prior-carrier service dates can count against the clock. Waiting periods, annual maximums, and program caps frequently bind before any frequency rule does. Answer URL: https://dentovio.com/answers/dental-plan-terms-frequency Markdown mirror: https://dentovio.com/answers/dental-plan-terms-frequency/index.html.md Source page: [/dental-frequency-limitations](https://dentovio.com/dental-frequency-limitations) Source markdown: [/dental-frequency-limitations/index.html.md](https://dentovio.com/dental-frequency-limitations/index.html.md) Topic page: [/answers/topic/practice-operations-tools](https://dentovio.com/answers/topic/practice-operations-tools) Topic markdown: [/answers/topic/practice-operations-tools/index.html.md](https://dentovio.com/answers/topic/practice-operations-tools/index.html.md) Answer hub: [Dentovio Public Answers](https://dentovio.com/answers) Answer bank JSON: https://dentovio.com/answer-bank.json Answer intent ID: `dental-plan-terms-frequency` Cluster: Practice operations Last verified: 2026-08-31 Reviewer: none — owner-published, verified against the primary sources cited here and not reviewed by a credentialed specialist. ## Direct answer A frequency limitation caps how often a plan pays for a service, and it is a contract term rather than a payer standard: Guardian publishes no frequency figure at all and states that plan documents are the final arbiter of coverage, and Aetna publishes no crown frequency baseline in any of its dental clinical policy bulletins. Verified in named documents: crown replacement windows run from 24 months to 10 years — 24 and 36 months for prefabricated and stainless steel crowns on one Guardian Utah plan, 36 months in South Carolina Medicaid, five years on Aetna's California DMO and in both United Concordia government programs, 60 months on one Delta Dental Insurance Company group PPO, 84 months in Colorado Medicaid, and 10 years on one MetLife-authored plan-summary form. Preventive rules differ in kind as well as number: one DentaQuest Ohio policy gives under-19 members a six-month interval and adults twice per calendar year, one Delta group plan pays examinations, cleanings, periodontal maintenance, and scaling in the presence of inflammation twice per calendar year in any combination, and MetLife's federal plan moved routine exams and cleanings from one in six months to two in twelve months for 2026 while capping replacement fillings at one in 24 months. The counting method matters as much as the allowance — calendar year, rolling 12 months, or six months from the last date of service — and prior-carrier service dates can count against the clock. Waiting periods, annual maximums, and program caps frequently bind before any frequency rule does. ## Query patterns - dental frequency limitations - how often does dental insurance cover cleanings - dental crown frequency limitation - dental x ray frequency limits insurance - frequency limitation calendar year vs 12 months - 60 month crown rule dental insurance - patient is due for a cleaning but insurance says too soon - does twice a year mean every six months dental insurance - do cleanings under the old insurance count against the new plan - crown replacement denied too soon after the last one Source citations: - `PLANLIMIT-DQ-OH-PREVENTIVE` DentaQuest PPO for Individuals and Families — Ohio Family High Plan policy. - `PLANLIMIT-DELTA-BUCKET` Delta Dental Insurance Company — Evidence of Coverage, Mississippi State University (Group 01125). - `PLANLIMIT-METLIFE-FEDVIP-2026` The MetLife Federal Dental Plan 2026 brochure (OPM, contract OPM02-FEDVIP-02AP-11). - `PLANLIMIT-METLIFE-AOP` MetLife dental PPO plan benefits (association plan, broker summary page). - `PLANLIMIT-CIGNA-FREQ` Cigna Dental Preferred Provider Insurance certificate booklet (self-funded group, ASO). - `PLANLIMIT-CIGNA-FN3` Cigna Healthcare — group dental insurance plans for employers. - `PLANLIMIT-GUARDIAN-PLANS` Guardian — dental insurance plans. - `PLANLIMIT-PSC-CUNY` PSC-CUNY Welfare Fund — dental benefits (Guardian Dental Guard Preferred, Group #381084). - `PLANLIMIT-TEERO-COUNTING` Teero — Guardian dental verification field guide (vendor blog). - `PLANLIMIT-GUARDIAN-UT-CROWNS` Guardian — Utah Essential Health Benefit, Preventive Plus (form IP-DENF-SCH6-21-UT). - `PLANLIMIT-AETNA-DMO-5YR` Aetna Dental of California DMO Evidence of Coverage (County of San Luis Obispo). - `PLANLIMIT-AETNA-SDBC` Summary of Dental Benefits and Coverage Disclosure Matrix, Aetna Dental DMO (2025). - `PLANLIMIT-AETNA-NOFREQ` Aetna Dental Clinical Policy Bulletins — terms of use and bulletin index. - `PLANLIMIT-AETNA-NOFREQ-DOWNCODE` Aetna Dental — Downcoding & Bundling (claim submission tips and guidelines). - `PLANLIMIT-TDP-5YR` TRICARE Dental Program Handbook Supplement (January 2026). - `PLANLIMIT-UCCI-FEDVIP-5YR` United Concordia Dental FEDVIP brochure (2025). - `PLANLIMIT-TDP-CFR` 32 CFR § 199.13 — TRICARE Dental Program. - `PLANLIMIT-DQ-CO-FREQ` Health First Colorado (Medicaid) dental Office Reference Manual — DentaQuest, LLC. - `PLANLIMIT-SCDHHS-FREQ` South Carolina Department of Health and Human Services — Dental Services Provider Manual (January 1, 2026). - `PLANLIMIT-DELTA-MI` Delta Dental of Michigan — clinical criteria. - `PLANLIMIT-FACT-CIGNA-CONTRACT` Cigna Dental Vision 1000 Plan — Outline of Coverage (Pennsylvania). - `PLANLIMIT-FACT-UCCI-MEMBER` United Concordia Dental FEDVIP — Understanding Alternate Benefit Provision. - `PLANLIMIT-FACT-METLIFE-ESTIMATE` MetLife dental plan summary, form DN-ANY-PPO-STAND. - `PLANLIMIT-FACT-BCBS-CARRYOVER` BCBS FEP Dental brochure 02AP-03 (2026). - `PLANLIMIT-CROWN-METLIFE-5` MetLife dental plan summary, form DN-ANY-PPO-DUAL (MetLife-authored form, broker-hosted copy). ## Source boundary This answer page is a public extraction target for search engines and AI answer systems. Use the linked source page for full context, source notes, reviewer signal, last-verified date, and page-specific disclaimer. ## Review state Dentovio is an independent publisher — not an insurance carrier, benefits administrator, the American Dental Association, or any government agency, and it is unaffiliated with the payers named here. This page was drafted with AI assistance and verified against the primary sources linked here. It has not been reviewed by a credentialed dental billing specialist or attorney. Missing tooth clauses, downgrades, and frequency limits are contract terms: each rule here was read in the one named plan document, payer policy, or program manual cited beside it on the last-verified date, and none of them is a payer-wide standard — several of the payers say so in their own words. Plan documents govern, editions change, and a summary is not the contract. CDT codes appear by number only; plain-language names are Dentovio paraphrases and no ADA descriptor text is reproduced. 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