1.Some of my benefits indicate a maximum number of Units allowed. What is a Unit?
A Unit is a measurement of time in dentistry – 1 unit is equal to 15 minutes.
2.Is the facility fee charged by my oral surgeon covered under this Plan?
This Plan does not cover the facility fee charge. The cost of the extractions and the associated anesthesia would be eligible for consideration under this Plan.
3.My tooth was removed 20 years ago and I now want to replace it now with a denture or bridge. I have only been with this Plan for 6 years. Would this be denture/bridge be covered?
The tooth or teeth being replaced must have been removed during the time you were covered by this Plan for the appliance (denture/bridge) to be eligible for coverage under this Plan. As you you have only been covered by this Plan for 6 years the initial appliance would not be covered
4.Do you cover root canal retreatment?
The maximum financial reimbursement for root canal retreatment is limited to the cost for a standard root canal. You can have your dentist submit an estimate to determine the exact amount available.
5.Can you refer me to a dentist?
We do not do referrals, however, you may be able to get assistance in locating a dentist in your area by contacting your provincial dental association directly or checking their website for a dentist locator search or dentist directory.
6.Can I use my dentist’s standard claim form to submit a claim?
Yes, provided all the critical information is included on the claim form completed by your dentist for the services rendered. You are responsible for ensuring the following information is included
- Member’ s full name, date of birth, address
- Name of patient – date of birth and relationship to member
- If dependent child 21 and over – student status- employment status
- Co-ordination of benefits confirmation and information
- Accidental dental injury information if applicable
- If denture/crown or bridge- initial/replacement/ age and condition
- Claim form MUST be signed by the member before submitting