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Dental

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.

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 $750 per benefit year.

Diagnostic & Preventative
Your plan covers 80% of diagnostic and preventative procedures including:
• examination, 1 per benefit year
• complete series of x-rays, up to 16 films including bitewings, 1 in any 36 month period, not eligible for dependent children under age 12
• bitewings, 1 per benefit year
• panoramic, 1 in any 36 month period
• polishing, 1 unit per benefit year
• scaling, 2 units per benefit year

Minor Restorative
Your plan covers 70% for services associated with dental health restoration, including:
• amalgam (silver) fillings
• composite resin (tooth coloured) fillings for anterior teeth only. White fillings placed on molars will be reimbursed at the silver (amalgam) rate
• stainless steel and plastic full coverage restoration, 1 per tooth in any 36 month period, for dependent children under age 15
• recementation of fixed prosthetics
• denture adjustments and repairs
• relining, rebasing and tissue conditioning, once every 36 months

Extractions
Your plan covers 50% for services associated with surgical extractions, including:
• extractions, not more than 2 wisdom teeth per benefit year
• anaesthesia, eligible when done in conjunction with oral surgical procedures

Endodontic
Your plan covers 20% for endodontic services including:
• root canal therapy

Periodontic
Your plan covers 20% for periodontic services including:
• occlusal equilibration, not more than 4 units per benefit year
• periodontal appliances, not more than 1 appliance per arch in any 5 year period
• periodontal appliance repairs, maintenance and adjustments, 1 per benefit year
• oral surgical procedures
• anaesthesia, eligible when done in conjunction with oral surgical procedures