What Is Not Covered Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 44 18. Outside of initial assessment, services as treatments for the primary diagnoses of learning disabilities, pyromania, kleptomania, and paraphilic disorders. 19. Outside of initial assessment, unspecified disorders for which the Provider is not obligated to provide clinical rationale as defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association. 20. School-based Intensive Behavioral Therapies (IBT) service or services that are otherwise covered under the Individuals with Disabilities Education Act (IDEA). 21. Services performed in connection with conditions not classified in the current edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association. 22. Transitional living services. 23. Tuition for or services that are school-based for children and adolescents required to be provided by, or paid for by, the school under the Individuals with Disabilities Education Act. 24. Intense Early Intervention Using Behavioral Therapy (IEIBT) and Lovaas. This exclusion does not apply when required for the treatment of Autism Spectrum Disorders. 25. Vagus nerve stimulator treatment for the treatment of depression and quantitative electroencephalogram treatment of behavioral health conditions. 26. Wilderness, adventure, camping, outdoor, or other similar programs. Dental 27. Dental braces (orthodontics). 28. Dental care (which includes dental x-rays, supplies, and appliances and all associated expenses, including hospitalizations and anesthesia). This exclusion does not apply to accidental-related dental services for which Benefits are provided as described under Dental Services – Accidental and Medical in Section 5.1 (Covered Health Services). This exclusion does not apply to dental care (oral exam, x-rays, extractions and non-surgical elimination of oral infection) required for the direct treatment of a medical condition for which Benefits are available under the Plan. 29. Dental care that is required to treat the effects of a medical condition, but that is not necessary to directly treat the medical condition, is excluded. Examples include treatment of dental tooth decay or cavities resulting from dry mouth after radiation treatment or as a result of medication. 30. Dental implants, bone grafts, and other implant-related procedures. 31. Endodontics, periodontal surgery, and restorative treatments are excluded. 32. Preventive care, diagnosis, and treatment of or related to the teeth, jawbones, or gums. 33. Treatment of congenitally missing, malpositioned or supernumerary (extra) teeth, even if part of a congenital anomaly.