Maximum Number of Days per Trip = 60 days.

$5,000,000 per covered person per benefit year for Emergency Services.

$75,000 per covered person per benefit year for referral service.

The patient must contact GSC Travel Assistance within 48 hours of commencement of treatment. Failure to notify them within 48 hours may result in benefits being limited to only those expenses incurred within the first 48 hours of any and each treatment/incident or the plan maximum, whichever is the lesser of the two.

Call Green Shield customer service centre at 1-888-525-7587 for more information.

Reimbursement for the services of a licensed dental practitioner for dental care to natural teeth when necessitated by a direct blow to the mouth and not by an object wittingly or unwittingly placed in the mouth. The accident must occur while the coverage is in force. When natural teeth have been damaged eligible services are limited to one set of artificial teeth. You must notify Green Shield Canada immediately following the accident and the treatment must commence within 180 days of the accident.

Green Shield Canada will not be liable for any services performed after the earlier of

• 365 days following the accident; or
• the date you or your dependent cease to be covered under this plan.

No amount will be paid for periodontia or orthodontia treatments or the repair or replacement of artificial teeth.

Charges will be based on the current Provincial Dental Association Fee Guide for General Practitioners in the province where services are rendered. Approval will be based on the current status and/or benefit level of the covered person at the time that we are notified of the accident.

In the event of a dental accident, claims should be submitted under the health benefit plan before submitting them under the dental plan.

Pre-authorization required. An estimate for all dental accident services MUST be submitted to Green Shield Canada. If you go ahead with treatment without a pre-determination being approved, you are doing so at the risk of the expenses being yours.

Your plan covers 100% up to $15/hour to a maximum of $1,000 per benefit year for private tutorial service if the student is confined to home or hospital for a minimum of 15 consecutive school days.

Your plan provides coverage for the loss of life or limb and for paralysis caused by an accident. The amount of your life benefit is $5,000. Please contact the health and dental plan office for a complete schedule of losses.