GPC - mystudentplan - Dental Benefits

Plan Number: 165356
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.

Coverage is a combined maximum of $750 per benefit year

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:

Dental Benefits	Coverage
Preventative Services	80%	Recall examination Once every 12 months Initial or complete exams Once every 36 months Specific or emergency exams Complete series of x-rays and periapical Maximum 16 films including bitewings, 1 in any period of 36 months Bitewings Maximum 4 films every 12 months Panoramic 1 in any period of 36 months Polishing 1 unit every 12 months Scaling 4 units per benefit year Fluoride Every 12 months Oral hygiene instruction Once every 12 months Pit and fissure sealants Removal of impacted teeth Anaesthesia Eligible when done in conjunction with a covered dental procedure Space maintainers and maintenance Under 15 years of age
Basic Services	70%	Fillings - amalgam, composite, acrylic or equivalent. You are only covered for composite fillings in front teeth and pre-molars
Other Basic Services	60%	extractions and anaesthesia Eligible when done in conjunction with oral surgical procedures. Except removal of impacted teeth which is covered under Preventative Services. Prefabricated metal restorations and repairs to prefabricated metal restorations Other than in conjunction with the placement of permanent crowns Root canal therapy Root planing and occlusal equilibration are each limited to 8 units per benefit year 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.

Online Forms Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications within 30 days from the start date of your program.

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.

Dental Benefits

Coverage is a combined maximum of $750 per benefit year

Limitations and Exclusions to Dental Benefits

Benefits Plan Office

General Inquiries Line

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