LCSA - mystudentplan - Dental Benefits

Plan Number: 330842
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 combination 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 different treatments and coverages included:

Dental Benefits	Coverage
Diagnostic & Preventative	80%	Recall examination Once per benefit year. Initial or complete exams once every 36 months. Specific or emergency exams. Complete series of x-rays Not eligible for dependants under 12 and periapical, maximum 16 films including bitewings, once in any period of 36 months. Bitewings Maximum 4 films per benefit year. Panoramic Once in any period of 36 months. Polishing Once unit per benefit year. Scaling 2 units per benefit year. Fluoride Under 19 years of age, 1 treatment per benefit year. Oral hygiene instruction 1 treatment per lifetime. 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%	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. Recementation of existing restorations. Denture adjustments and repairs. Relining, rebasing and tissue conditioning One treatment in any period of 36 months.
Periodontic	15%	Occlusal equilibration Maximum 4 units per benefit year. Periodontal appliances 1 appliance per arch in any period of 24 months. Periodontal appliance repairs, maintenance and adjustments Maximum 4 adjustments per benefit year. Oral surgical procedures. Anaesthesia Eligible when done in conjunction with oral surgical procedures.
Endodontic	20%	Root canal therapy
Oral Surgery	50%	Extractions Maximum 2 wisdom teeth per benefit year. Anaesthesia Eligible when done in conjunction with oral surgical procedures.

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 September 25^th, 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.