SABVC - mystudentplan - Dental Benefits

Plan Number: 330760
Certificate Number: Student ID
FAQ
Canada Life: 1-800-957-9777
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Student Health and Wellness! mystudentplan provides health, prescriptions, dental, mental health care plus additional benefits for eligible students.

Dental Benefits

The student dental plan can ease the costs of regular check ups, cleanings and a variety of dental procedures to make a plan for your oral health.

All students are automatically enrolled in the Balanced Plan

Ask your dentist to submit a pre-authorization to Canada Life prior to any dental treatment plan exceeding $500.

These are the different treatments and coverages included:

Health Benefits	Balanced Plan	FLEXible Drug & Parameds	FLEXible Vision & Parameds	FLEXible Dental
Dental Coverage	$650 per benefit year	$400 per benefit year	$650 per benefit year	$900 per benefit year
Diagnostic & Preventative	80% Coverage	80% Coverage	80% Coverage	80% Coverage
	1 recall (12 months) examination per benefit year.			2 recall (every 6 months) examination per benefit year.
	Initial or complete examination 1 per dentist in a lifetime Complete series of x-rays Maximum 16 films including bitewings in any period of 36 months. Not eligible for dependents under 12 and periapical. Bitewings Maximum 4 films per benefit year. Panoramic 1 in any period of 36 months. Scaling 2 units per benefit year. Polishing 1 unit per benefit year. Oral hygiene instruction 1 treatment per lifetime. Fluoride Under 19 years of age, 1 treatment per benefit year. Pit and fissure sealants under 19 years of age, 1 per molar in any period of 36 months. Anaesthesia eligible when done in conjunction with a covered dental procedure.
Minor Restorative	70% Coverage	50% Coverage	60% Coverage	80% Coverage
Minor Restorative	Space maintainers and maintenance Under 15 years of age. Amalgam and tooth coloured fillings 1 per tooth in any period of 24 months. Stainless steel and plastic full coverage restorations Under 15 years of age, 1 per tooth in any period of 36 months. Denture adjustments and repairs. Relining, Rebasing and Tissue conditioning 1 treatment in any period of 36 months. Recementation of existing restorations
Oral Surgery	50% Coverage	30% Coverage	30% Coverage	80% Coverage
Oral Surgery	Extractions Maximum 2 wisdom teeth per benefit year. Anaesthesia Eligible when done in conjunction with Oral Surgery
Endodontic	20% Coverage
Endodontic	Root canal therapy Anaesthesia Eligible when done in conjunction with Oral Surgery
Periodontic	15% Coverage
Periodontic	Occlusal equilibration Maximum 4 units per benefit year Periodontal appliances Maximum 1 appliance per arch in any period of 24 months. Periodontal appliance repairs, maintenance and adjustments Maximum 4 adjustments per benefit year. Anaesthesia Eligible when done in conjunction with Oral Surgery

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.

Limitations and Exclusions to Dental Benefits

An exclusion is a condition or instance that is not covered by the Dental Plan. It's important to review and understand exclusions to the plan before using your benefits.

Fall Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by October 2^nd, 2024

Plan Card Generator
Generate your Plan Card and use it where direct billing to Canada Life is available.

Prescription Search Tool
Find out if your prescription drugs are covered by the student plan.

Plan Claims
Learn more about submitting online or manual claims to Canada Life to get your refund.

Benefits Plan Office

Email: bowvalleyplan@mystudentplan.ca
Phone: 403-456-3080
address: Room S2034 Bow Valley College, South Campus, 345 6 Ave SE.
Calgary, Alberta T2G 4V1, CA

General Inquiries Line

Monday to Friday
from 6:00am to 5:00pm MST
Phone: 1-877-746-5566 Extension 7249

Dental Benefits

All students are automatically enrolled in the Balanced Plan

Limitations and Exclusions to Dental Benefits

Benefits Plan Office

General Inquiries Line

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