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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 $300.

Your plan covers up to a maximum of $500 per benefit year.

Diagnostic & Preventative
Your plan covers 100% of diagnostic and preventative procedures including:
• recall examination, 1 per benefit year
• complete oral examination, 1 per dentist in a lifetime
• emergency or specific examination
• consultation, once per benefit year
• complete series of x-rays, (not eligible for dependents under 12) up to 16 films including bitewings, 1 in any 36 month period
• bitewings, not more than 4 films per benefit year
• panoramic, 1 in any 36 month period
• occlusal radiographs (no more than 4 films in any benefit year)
• periapical (no more than 16 films in any 36 consecutive months)
• polishing, 1 unit per benefit year
• scaling, 2 units per benefit year
• fluoride, 1 treatment per benefit year

Minor Restorative
Your plan covers 75% for services associated with dental health restoration, including:
• space maintainers and maintenance, under 15 years of age
• amalgam (silver) fillings, 1 per tooth in any period of 24 months
• composite resin (tooth colored) fillings, 1 per tooth in any period of 24 months, limited to once every two years on the same tooth surfaces
• silicate fillings, 1 per tooth in any period of 24 months

Oral Surgery
Your plan covers 75% for services associated with surgical extractions, including:
• wisdom teeth removal
• residual root removal
• anaesthesia, eligible when done in conjunction with oral surgical procedures

Service Members


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