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Payment of dental benefits is based on the General Practitioners Dental Association suggested fee guide or the Insurance Reimbursement Rate set by the Canadian Life and Health Insurance Association Inc. (CLHIA) when a fee guide is not available. For services provided by a dental specialist, payment is based upon the General Practitioners Dental Association suggested fee guide.

Services are covered at rates outlined in the 1997 Alberta Dental Association Fee Guide for General Practitioners, plus inflationary adjustments as determined by the insurance carrier. Should your dentist charge fees in excess of the fee guide, the additional costs are not covered.

Alternate Benefit - When there are two or more courses of treatment available to adequately correct a dental condition, reimbursement may be based on the cost of the least expensive treatment, which provides adequate care to the Insured.

IMPORTANT! Please submit a pre-determination/pre-authorization to the insurance carrier prior to treatment of specialist services and any treatment plan exceeding $500.

Your plan covers up to a maximum of $1000 per benefit year.

Diagnostic & Preventative
Your plan covers 80% of diagnostic and preventative procedures including:
• 6 month recall
• complete series of x-rays, 1 in any period of 36 months
• bitewings, not more than 4 films per benefit year
• panoramic, 1 in any period of 36 months
• polishing, 2 units per benefit year
• scaling, 2 units per benefit year
• fluoride, under 15 years of age, 1 treatment per benefit year
• pit and fissure sealants, under 16 years of age, 1 replacement per tooth, per lifetime, on permanent molars

Minor Restorative
Your plan covers 80% for services associated with dental health restoration, including:
• space maintainers and maintenance
• amalgam and tooth coloured fillings
• stainless steel and plastic full coverage restorations
• denture adjustments and repairs
• denture relining, rebasing and tissue conditioning
• recementation of fixed prosthesis
• denture relining, rebasing and tissue conditioning, one treatment in any period of 36 months
• recementation of fixed prosthesis

Oral Surgery
 Your plan covers 75% services associated with surgical extractions, including:
• simple extractions, impacted extractions, not more than 4 teeth per patient per benefit year
• anaesthesia, eligible when done in conjunction with Oral Surgery

Your plan covers 60% for endodontic services including:
• root canal therapy

Your plan covers 60% for periodontic services including:
• additional scaling and/or root planing, maximum 5 units per benefit year

Major Restorative
Your plan covers 15% for major restorative services including:
• crowns
• bridges
• dentures

Replacement of an existing crown, bridge or dentures is an eligible expense if the replacement is required to replace an existing crown, bridge or denture which was installed 5 years before the replacement.

Service Members

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