Dental Care Benefit. Dental Care Benefits are provided for you and your eligible dependents subject to the limitations and exclusions described below. Eligible services are all reasonable and customary dental services which are recommended as necessary and performed by a qualified dentist or physician and for which a Treatment Plan has been submitted to and approved by the insurer before the services are rendered. The filing of a Treatment Plan is not required if the total cost of the proposed work is less than $500 or if treatment is rendered in emergency conditions. Eligible dental services are classified under three major categories:
Dental Care Benefit. Claim must be submitted by the end of the calendar year following the year in which the expense was incurred except that proof of claim must be submitted within 90 days of the date on which your insurance is cancelled for any reason. A separate claim form must be filled out for each member of your family for whom you are making claim. The dentist's statement on this form, or any bills supporting your claim, must show the patient's name, dates and nature of the treatment and the charge. If the total cost associated with proposed dental work is $500 or more, a Treatment Plan must be submitted to the insurer as explained in Section 9. You should have your dentist complete a claim form setting out details as to the proposed treatment and the cost and send this form to the insurance company for their review. You will then be advised as to the charges, or portion thereof, which the insurer considers eligible for benefits. Upon completion of the dental treatment you again submit a claim to receive payment of the approved benefits. Failure to see your doctor promptly or to submit your claim together with the doctor's or dentist's report or other itemized statements within the above time limits will result in the rejection of your claim.
Dental Care Benefit. Dental care benefits are provided for you and your eligible dependents subject to the limitations and exclusions described below. Eligible services are all reasonable and customary dental services which are recommended as necessary and performed by a qualified dentist or physician and for which a Treatment Plan has been submitted to and approved by the insurer before the services are rendered. The filing of a Treatment Plan is not required if the total cost of the proposed work is less than $500 or if treatment is rendered in emergency conditions. Eligible dental services are classified under three major categories:
a. Basic Services - examinations and cleaning of teeth (once in any six-month period), fillings, fluoride treatment for dependants under 18 years old or if medically required and other necessary treatment for the relief of dental pain.
b. Restorative Services - crowns and inlays, bridge work, dentures, root canal therapy (endodontics), and the treatment of tissues and bones supporting the teeth (periodontics).
c. Orthodontia – extractions, proper fitting of natural teeth and prevention or correction of irregularities of the teeth. In addition, extractions shall be treated as an orthodontic procedure for purposes of reimbursement. You will be reimbursed for 90% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. After January 1, 2012 you will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $7,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000. At no time will the maximum exceed the original amount. After January 1, 2020, you will be reimbursed for 80% of the cost of eligible Basic Services incurred by you or your eligible dependents up to a maximum for each insured person of $1000 in a calendar year. You will also be reimbursed for 50% of the cost of Restorative Services and 50% of the cost of Orthodontia to a lifetime maximum benefit of $5,000 for each insured person for Restorative Services and Orthodontia combined. An annual reinstatement of up to $700 will be provided at the beginning of each calendar year, if required, to restore the lifetime maximum to the level of $7,000....
Dental Care Benefit. The Employer agrees to pay one hundred percent (100%) of the billed premium, subject to any applicable deductible(s), toward coverage of each Eligible Employee who qualifies and remains eligible for coverage.
Dental Care Benefit. Network Dental examinations including cleaning and bitewing x-rays will be available to covered individuals twice each year subject to a $20 copayment. The insurance carrier will establish an adequate network of dental providers to provide these services along with a discount on all other dental procedures. Coverage is provided for two fillings per year for an additional $10 copayment per filling.
Dental Care Benefit. The Employer shall make dental care available at its School of Dentistry to the employee, the employee's spouse or legally domiciled adult and dependents (dependents shall be as defined for Internal Revenue Service purposes). Such dental care shall be rendered in a manner consistent with the rules and regulations of the Dental Clinic and only on the same basis as available to members of the public. The fee for such services shall be waived for the employee, the employee's spouse or legally domiciled adult and dependents, up to a cap of $3,000 per individual per calendar year. Beyond the $3,000 cap amount, employees will be responsible to pay 25% of any remaining fees for the balance of that year.
Dental Care Benefit. If you are charged as each treatment is performed, will be reimbursed as each charge is incurred to the lifetime maximum of When there are two or more courses of dental treatment available to adequately correct a condition, this dental plan will provide reimbursement for the treatment which incurs the lowest cost consistent with dental care. Reimbursement of lab fees will be limited to the reasonable and customary charge in the area of service up to a maximum of of the suggested current fee guide for the particular dental treatment requiring the lab services. Predetermination of Benefits If the total cost of any proposed treatment is expected to exceed it is suggested that submit to a detailed treatment plan that the type and dates of treatment and the proposed charges. The Carrier will then advise you of the for which you will be reimbursed. If you change dentists at any point during the course of treatment, a new treatment plan will be required for reassessment. If you and your family are covered under the dental plan and your spouse's dental plan, the benefits payable under the plan will be co-ordinated so that the total amount you receive from both plans will not exceed of the expense incurred. Reimbursement be provided for emergency dental treatment rendered while outside Canada but only to the extent that you would have been reimbursed had this been rendered in the province where you normally reside.
Dental Care Benefit. Eligibility Waiting Period Dental Fee Guide Benefit Percentage Benefit Maximums Eligible Expenses Plan A - Eligible Expenses Endodontics, Periodontics, Oral Surgery - Plan B Major Restorative Treatment - Plan C
Dental Care Benefit of Benefit If the total cost of any proposed treatment is expected to exceed it is suggested you submit to Imperial Life a detailed treatment plan that outlines the type and anticipated dates of treatment and the proposed charges. Imperial Life will then advise you of the amount for which you will be reimbursed. If you change dentists at any point during the course of treatment, a new treatment plan will be required for re-assessment. Co-ordination of Benefits If you and your family are covered under this dental plan and your spouse’s dental plan, the benefits payable under this plan will be co- ordinated so that the total amount you receive from both plans will not exceed of the actual expense incurred. Travelling Outside Canada Reimbursement will be provided for emergency dental treatment rendered while travelling outside Canada but only to the extent that you would have been reimbursed had this treatment been rendered in the province where you normally reside. Basic and Preventative Treatment g any services that are primarily for orthodontic treatment complete oral examinations one in month period. recall oral examinations one in emergency or specific oral complete series of periapical films an to one in any month period. bitewing films and X-rays to progress of a particular temporomandibular joint film. laboratory examinations and duplicates. consultation with another Dentist. house or hospital call and after-hour! prophylaxis (light scaling and month period. office visit. once in any month period. topical application of fluoride and ani -cariogenic substances once in any month period. pit and fissure sealants. space for missing temporary dressing for the occlusal equilibration. amalgam, acrylic, silicate or compo than prefabricated veneer application retentative pins. preformed stainless steel and uncomplicated removal of erupted impacted teeth and residual roots. repair, and relining of par including the replacement of teeth or Repair of fixed bridgework. Anaesthesia required in relation to teeth and mouthguards. relief of pain. restorations (fillings) other crowns. and the surgical removal of or complete dentures, not a denture. surgery.
Dental Care Benefit. Eligible Expenses Eligible
