Frequently Asked Questions: New Dental Plan benefits
1- QUESTION: Please explain the following statement:
“Dental implants will be covered in their own right. (Currently, implants are partially covered by deeming them to be another procedure, i.e., a bridge or dentures).”
This means implants are now part of the drill down list of procedures (bridges, dentures). Please refer to question 2 for further information.
2- QUESTION: What percentage of implants are covered?
Implants are considered a major restorative procedure subject to 50% co-payment in addition to the annual plan limit, currently $2000.
3- QUESTION: Are crowns considered implants?
Crowns and Implant related crowns are two different types of major restoration.
Does that mean that dental implants have their own pocket of money? Or does the coverage caps off at 2,000$?
Coverage would be capped at $2000 in 2019 subject to deductibles, co-payment and provincial fee guide maximums. Should a member obtain an implant and their claim is reimbursed up to the plan max. At that point, any other dental procedures would likely exceed the plan max and would not likely be eligible to be reimbursed.
5- QUESTION: Does those changes apply to the Pensioners Dental Care Plan?
ANSWER: No. These changes do not apply to the Pensioners Dental Care Plan.
We strongly suggest that prior to any significant treatment where a member should submit a treatment plan to the administrator for benefit determination when the estimated cost of a course of treatment is three hundred ($300) or more.